J Korean Soc Emerg Med.
2019 Feb;30(1):22-32. 10.0000/jksem.2019.30.1.22.
Lactate/albumin ratio for the prediction of the development of sepsis-induced acute kidney injury in the emergency department
- Affiliations
-
- 1Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. grampian@yuhs.ac
- 2Department of Emergency Medicine, Graduate School of Medicine, Kangwon National University, Chuncheon, Korea.
- 3Department of Research Affairs, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.
- KMID: 2441122
- DOI: http://doi.org/10.0000/jksem.2019.30.1.22
Abstract
OBJECTIVE
The early prediction of acute kidney injury (AKI) in sepsis and the provision of prompt treatment may improve the outcomes. This study investigated the efficacy of the lactate/albumin ratio (LAR) in predicting severe AKI in cases of septic shock.
METHODS
This retrospective, observational cohort study was performed on patients integrated prospectively in a critical pathway of early-goal-directed therapy (EGDT)/SEPSIS. Adult patients with septic shock, who were admitted to the emergency department with a normal kidney function or stage 1 disease based on the Acute Kidney Injury Network classification between January 1, 2014 and September 30, 2017, were analyzed. The outcomes were the development of sepsis-induced severe AKI within 7 days.
RESULTS
A total of 343 patients were enrolled. An increase in the LAR value at admission (odds ratio [OR], 1.85; P=0.001) was a strong independent predictor of the development of severe AKI. The increasing predictability of AKI was closely associated with a L/A ratio≥0.794 at admission (OR, 14.66; P < 0.001). The area under the receiver operating characteristic curve value of the L/A ratio (0.821; 95% confidence interval [CI], 0.774-0.861; P < 0.01) was higher than that of lactate (0.795; 95% CI, 0.747-0.838; P < 0.01) for predicting severe AKI (P=0.032).
CONCLUSION
L/A ratio was found to be an independent predictor of the development of severe AKI in septic shock. The prognostic performance of the L/A ratio for predicting AKI of critically ill sepsis patients was superior to that of lactate measurements.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Identification of Biomarkers for the Diagnosis of Sepsis-Associated Acute Kidney Injury and Prediction of Renal Recovery in the Intensive Care Unit
- Plasma Neutrophil Gelatinase-associated Lipocalin is an Early Marker of Acute Kidney Injury
- Is There A Relationship Between Acute Kidney Injury and Use of Enhanced Computed Tomography in Septic Patients Presenting to An Emergency Center?
- The prognostic usefulness of the lactate/albumin ratio for predicting multiple organ dysfunction syndrome in severe trauma
- Usefulness of ischemia-modified albumin in the diagnosis of sepsis/septic shock in the emergency department
