Lactate/albumin ratio for the prediction of the development of sepsis-induced acute kidney injury in the emergency department
- Author:
Jeong Woo LEE
1
;
Je Sung YOU
;
Sung Phil CHUNG
;
Minhong CHOA
;
Taeyoung KONG
;
Dong Ryul KO
;
Yoon Jung HWANG
;
Yong Hee LEE
;
Incheol PARK
;
Sinae KIM
Author Information
1. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. grampian@yuhs.ac
- Publication Type:Original Article
- Keywords:
Sepsis;
Acute kidney injury;
Lactic acid;
Albumins;
Prognosis
- MeSH:
Acute Kidney Injury;
Adult;
Albumins;
Classification;
Cohort Studies;
Critical Illness;
Critical Pathways;
Emergencies;
Emergency Service, Hospital;
Humans;
Kidney;
Lactic Acid;
Prognosis;
Prospective Studies;
Retrospective Studies;
ROC Curve;
Sepsis;
Shock, Septic
- From:Journal of the Korean Society of Emergency Medicine
2019;30(1):22-32
- CountryRepublic of Korea
- Language:Korean
-
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.
