Lei Lei, Liang Yuling, Chen Jingyan, Cui Tianjiao, Fang Junxuan, Fei Lingyan, Lin Wenjian, Tang Chun, Jiang Shan, Wang Xiaohua
Department of Nephrology, Center of Kidney and Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Sci Rep. 2025 Jul 31;15(1):27994. doi: 10.1038/s41598-025-12949-w.
Acute kidney injury (AKI) is a critical postoperative complication in non-cardiac surgery patients, significantly impacting patient outcomes. The neutrophil percentage-to-albumin ratio (NPAR) is a promising inflammatory biomarker for predicting AKI. However, it is still unclear whether NPAR could be used as a predictor of postoperative AKI in Non-Cardiac Surgical Patients. Univariate and multivariable logistic regression analyses were conducted to assess the predictive value of NPAR for postoperative AKI, controlling for potential confounders. A total of 3041 patients were considered for the analysis after excluding those with preoperative infections and chronic kidney disease. The area under the receiver operating characteristic (ROC) curve for NPAR was 0.723, indicating moderate predictive capability for postoperative AKI. The optimal threshold for NPAR was 5.310, with a specificity of 0.640 and a sensitivity of 0.729. Multivariable regression analysis revealed that NPAR was significantly associated with postoperative AKI risk (adjusted odds ratio 1.093, 95% CI 1.072-1.116, P < 0.001), independent of other clinical factors. Preoperative NPAR is a significant predictor of postoperative AKI in non-cardiac surgical patients under general anesthesia and could be a valuable biomarker for identifying non-cardiac surgical patients at high-risk of AKI.
急性肾损伤(AKI)是非心脏手术患者术后的一种严重并发症,对患者预后有重大影响。中性粒细胞百分比与白蛋白比值(NPAR)是一种很有前景的预测AKI的炎症生物标志物。然而,NPAR是否可作为非心脏手术患者术后AKI的预测指标仍不清楚。进行单因素和多因素逻辑回归分析以评估NPAR对术后AKI的预测价值,并控制潜在的混杂因素。在排除术前有感染和慢性肾病的患者后,共纳入3041例患者进行分析。NPAR的受试者工作特征(ROC)曲线下面积为0.723,表明其对术后AKI具有中等预测能力。NPAR的最佳阈值为5.310,特异性为0.640,敏感性为0.729。多因素回归分析显示,NPAR与术后AKI风险显著相关(调整优势比1.093,95%可信区间1.072-1.116,P<0.001),独立于其他临床因素。术前NPAR是全身麻醉下非心脏手术患者术后AKI的重要预测指标,可能是识别AKI高危非心脏手术患者的有价值生物标志物。
EBioMedicine. 2024-9