Prognostic value of neutrophil-to-lymphocyte ratio dynamics in patients with septic acute kidney injury: a cohort study
Background Neutrophil-to-lymphocyte ratio (NLR) has been suggested to be a prognostic marker for various diseases, but whether NLR dynamics (ΔNLR) is related to mortality and disease severity in patients with septic acute kidney injury (AKI) has not been determined.Methods Between August 2013 and Au...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2343818 |
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| author | Wei Wei Caihong Liu Guojiao Song Letian Yang Jian Li Bo Wang Ting Yin Yingying Yang Liang Ma Ling Zhang Ping Fu Yuliang Zhao |
| author_facet | Wei Wei Caihong Liu Guojiao Song Letian Yang Jian Li Bo Wang Ting Yin Yingying Yang Liang Ma Ling Zhang Ping Fu Yuliang Zhao |
| author_sort | Wei Wei |
| collection | DOAJ |
| description | Background Neutrophil-to-lymphocyte ratio (NLR) has been suggested to be a prognostic marker for various diseases, but whether NLR dynamics (ΔNLR) is related to mortality and disease severity in patients with septic acute kidney injury (AKI) has not been determined.Methods Between August 2013 and August 2021, septic AKI patients at our center were retrospectively enrolled. ΔNLR was defined as the difference between the NLR at septic AKI diagnosis and at hospital admission. The relationship between the ΔNLR and mortality was evaluated by Kaplan–Meier curves, Cox proportional hazards, and cubic spline analyses. The prediction values were compared by area under the receiver-operating characteristic curve (AUROC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) analyses.Results Of the 413 participants, the mean age was 63 ± 17 years, and 134 were female (32.4%). According to the median value, patients in the high-ΔNLR group had significantly greater 90-d mortality (74.4% vs. 46.6%, p < 0.001). After adjustment for potential confounders, high ΔNLR remained an independent predictor of 90-d mortality (HR = 2.80; 95% CI = 1.74–4.49, p < 0.001). Furthermore, ΔNLR had the highest AUROC for 90-d mortality (0.685) among the various biomarkers and exhibited an improved NRI (0.314) and IDI (0.027) when incorporated with PCT and CRP. For secondary outcomes, patients with high ΔNLR had increased risk of 30-d mortality (p = 0.004), need for renal replacement therapy (p = 0.011), and developing stage-3 AKI (p = 0.040) according to the adjusted models.Conclusions High ΔNLR is independently associated with increased risk of patient mortality and adverse outcomes. ΔNLR might be utilized to facilitate risk stratification and optimize septic AKI management. |
| format | Article |
| id | doaj-art-a8f98236a5b94adda8c78c3d62ba0861 |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-a8f98236a5b94adda8c78c3d62ba08612025-01-23T04:17:48ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146110.1080/0886022X.2024.2343818Prognostic value of neutrophil-to-lymphocyte ratio dynamics in patients with septic acute kidney injury: a cohort studyWei Wei0Caihong Liu1Guojiao Song2Letian Yang3Jian Li4Bo Wang5Ting Yin6Yingying Yang7Liang Ma8Ling Zhang9Ping Fu10Yuliang Zhao11Division of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaDivision of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaWest China School of Medicine, Sichuan University, Chengdu, PR ChinaDivision of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaDivision of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaDivision of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaDivision of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaDivision of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaDivision of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaDivision of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaDivision of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaDivision of Nephrology, West China Hospital, Sichuan University, Chengdu, PR ChinaBackground Neutrophil-to-lymphocyte ratio (NLR) has been suggested to be a prognostic marker for various diseases, but whether NLR dynamics (ΔNLR) is related to mortality and disease severity in patients with septic acute kidney injury (AKI) has not been determined.Methods Between August 2013 and August 2021, septic AKI patients at our center were retrospectively enrolled. ΔNLR was defined as the difference between the NLR at septic AKI diagnosis and at hospital admission. The relationship between the ΔNLR and mortality was evaluated by Kaplan–Meier curves, Cox proportional hazards, and cubic spline analyses. The prediction values were compared by area under the receiver-operating characteristic curve (AUROC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) analyses.Results Of the 413 participants, the mean age was 63 ± 17 years, and 134 were female (32.4%). According to the median value, patients in the high-ΔNLR group had significantly greater 90-d mortality (74.4% vs. 46.6%, p < 0.001). After adjustment for potential confounders, high ΔNLR remained an independent predictor of 90-d mortality (HR = 2.80; 95% CI = 1.74–4.49, p < 0.001). Furthermore, ΔNLR had the highest AUROC for 90-d mortality (0.685) among the various biomarkers and exhibited an improved NRI (0.314) and IDI (0.027) when incorporated with PCT and CRP. For secondary outcomes, patients with high ΔNLR had increased risk of 30-d mortality (p = 0.004), need for renal replacement therapy (p = 0.011), and developing stage-3 AKI (p = 0.040) according to the adjusted models.Conclusions High ΔNLR is independently associated with increased risk of patient mortality and adverse outcomes. ΔNLR might be utilized to facilitate risk stratification and optimize septic AKI management.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2343818Septic acute kidney injuryneutrophil-to-lymphocyte ratio dynamicsprognosismortality |
| spellingShingle | Wei Wei Caihong Liu Guojiao Song Letian Yang Jian Li Bo Wang Ting Yin Yingying Yang Liang Ma Ling Zhang Ping Fu Yuliang Zhao Prognostic value of neutrophil-to-lymphocyte ratio dynamics in patients with septic acute kidney injury: a cohort study Renal Failure Septic acute kidney injury neutrophil-to-lymphocyte ratio dynamics prognosis mortality |
| title | Prognostic value of neutrophil-to-lymphocyte ratio dynamics in patients with septic acute kidney injury: a cohort study |
| title_full | Prognostic value of neutrophil-to-lymphocyte ratio dynamics in patients with septic acute kidney injury: a cohort study |
| title_fullStr | Prognostic value of neutrophil-to-lymphocyte ratio dynamics in patients with septic acute kidney injury: a cohort study |
| title_full_unstemmed | Prognostic value of neutrophil-to-lymphocyte ratio dynamics in patients with septic acute kidney injury: a cohort study |
| title_short | Prognostic value of neutrophil-to-lymphocyte ratio dynamics in patients with septic acute kidney injury: a cohort study |
| title_sort | prognostic value of neutrophil to lymphocyte ratio dynamics in patients with septic acute kidney injury a cohort study |
| topic | Septic acute kidney injury neutrophil-to-lymphocyte ratio dynamics prognosis mortality |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2343818 |
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