Hua Yiming, Ding Ning, Jing Huaizhi, Xie Yifei, Wu Hao, Wu Yue, Lan Beidi
Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Key Laboratory of Molecular Cardiology, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Front Physiol. 2025 Feb 19;16:1469866. doi: 10.3389/fphys.2025.1469866. eCollection 2025.
Lactate-to-albumin ratio (LAR) is an emergency predictive indicator of sepsis-related mortality. An elevated LAR is associated with poor outcomes in critically ill patients. However, its predictive value for acute kidney injury (AKI) in patients with sepsis remains unclear. Therefore, this study aimed to investigate the relationship between LAR and AKI in patients with sepsis.
The study population was derived from the Medical Information Mart for Intensive Care-IV (2.0) database and stratified into quartiles based on the LAR. The primary endpoint was the occurrence of AKI. The secondary endpoints were the use of renal replacement therapy (RRT) and in-hospital mortality. Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess the association between the LAR index and risk of AKI in patients with sepsis.
In this study, 5,222 patients with sepsis were included, of whom 3,029 were male (58%). Kaplan-Meier survival analysis demonstrated significant differences in the cumulative incidence of AKI and cumulative usage rate of RRT among patients with sepsis based on the quartiles of the LAR index. Additionally, Cox proportional hazards analysis adjusted for confounding factors showed a significant association between the LAR index and incidence of AKI in patients with sepsis.
Our study indicated that a high LAR index can serve as an independent predictor of AKI in patients with sepsis.
乳酸与白蛋白比值（LAR）是脓毒症相关死亡率的一项紧急预测指标。LAR升高与危重症患者的不良预后相关。然而，其对脓毒症患者急性肾损伤（AKI）的预测价值仍不明确。因此，本研究旨在探讨脓毒症患者中LAR与AKI之间的关系。
研究人群来自重症监护医学信息数据库-IV（2.0版），并根据LAR分为四分位数。主要终点是AKI的发生。次要终点是肾脏替代治疗（RRT）的使用和院内死亡率。采用Kaplan-Meier生存分析和Cox比例风险模型评估LAR指数与脓毒症患者AKI风险之间的关联。
本研究纳入了5222例脓毒症患者，其中3029例为男性（58%）。Kaplan-Meier生存分析显示，基于LAR指数四分位数的脓毒症患者中，AKI的累积发生率和RRT的累积使用率存在显著差异。此外，经混杂因素调整的Cox比例风险分析显示，LAR指数与脓毒症患者AKI的发生率之间存在显著关联。
我们的研究表明，高LAR指数可作为脓毒症患者AKI的独立预测指标。
