Clinical study on neutrophil to lymphocyte and platelet ratio with acute kidney injury in elderly patients with sepsis / 中华急诊医学杂志

ABSTRACT

Objective:The present study aimed to explore the clinical value of neutrophil to lymphocyte and platelet ratio (NLPR) for acute kidney injury (AKI) in elderly patients with sepsis.Methods:This was a retrospective analysis of 360 elderly patients with sepsis or septic shock who were admitted to Intensive Care Unit (ICU) of Zhongnan Hospital of Wuhan University. They were divided into AKI and non-AKI groups based on the KDIGO-AKI criteria. The independent risk factors of AKI were identified via logistic regression analysis, and the calculation of the receiver-operating characteristic (ROC) curves were used to evaluate the diagnostic capability of NLPR for AKI and the short-term outcome of sepsis patients.Results:Total of 195 (54.2%) patients were attributed to the AKI group, while 165 (45.8%) patients were allocated to the non-AKI group. The median of NLPR was significantly higher in the AKI group compared with the non-AKI group ( Z=8.640, P<0.001). Compared with the non-AKI group, the in-hospital death and the length of ICU stay increased (all P<0.05). Patients with AKI required more vasoactive drugs, mechanical ventilation, and renal replacement therapy (all P<0.05). After adjusting the demographic and clinical variables, multivariate logistic regression analysis showed that NLPR was an independent risk factor of AKI ( OR=1.016, 95% CI 1.002-1.030, P=0.027). The ROC curves showed the excellent clinical value of NLPR and which was significantly higher than the neutrophil to lymphocyte ratio (NLR) and serum creatinine. In addition, the present study revealed that the NLPR was also positively correlated with the stage of AKI ( r=0.525, P<0.001). Conclusions:The NLPR is derived from a complete blood cell count, as a new comprehensive inflammatory parameter that is simple and easily available, it is an independent risk factor for AKI in elderly sepsis patients, and should be paid attention in the clinical practice.