Prognostic implication of lactic dehydrogenase-to-albumin ratio in critically ill patients with acute kidney injury

Abstract

Background No studies have been published on the correlation between lactic dehydrogenase-to-albumin ratio (LAR) and poor prognosis of acute kidney injury (AKI) patients, warranting further research. This analysis sought to investigate the prognostic implication of LAR in critically ill patients with AKI. Methods The present study enrolled 11,046 and 5180 adults with AKI from the Medical Information Mart for Intensive Care III (MIMIC III) and MIMIC IV, respectively. Data from MIMIC IV were identified as the training cohort, and those from MIMIC III were identified as the validation cohort. We applied multivariate regression analysis to identify the link between LAR and all-cause mortality. Restricted cubic spline (RCS) was conducted to figure out the correlation between LAR and in-hospital mortality. Furthermore, we carried out stratification analyses to examine if the effects of LAR on in-hospital mortality were consistent across various subclasses. Results The level of LAR was remarkably higher in the in-hospital non-survivor group ( p < 0.001). Furthermore, the increased LAR group presented a remarkably higher rate of in-hospital mortality at AKI stages 1, 2, and 3 compared with the decreased LAR group (all p < 0.001). Multivariate regression analyses exhibited the independent prognostic significance of LAR for all-cause mortality (all p < 0.001). MIMIC III observed concordant results. RCS indicated a non-linear correlation between LAR and in-hospital death ( P for non-linearity < 0.001). The relationship between LAR and in-hospital mortality was still significant in patients with various subclasses. Conclusions Elevated LAR at admission is a prognostic risk factor for critically ill patients with AKI. Supplementary Information The online version contains supplementary material available at 10.1007/s10157-023-02321-5.

Prognostic value of lactic dehydrogenase-to-albumin ratio in critically ill patients with acute respiratory distress syndrome: a retrospective cohort study

“…Yan et al reported that high LAR was related to an increased risk of SAP in patients with acute ischemic stroke and LAR may be a potential predictor for the incidence of SAP ( 9 ). In addition, LAR had good predictive value for the prognosis of severe infection ( 10 ) and acute kidney injury ( 11 ). Therefore, we had ample reasons to believe that LAR is also associated with the prognosis of ARDS of the ICU.…”

“…In the report of Jin et al , retrospective analysis was conducted on the correlation between pre-treatment and post-treatment LDH levels to treatment response and survival rate in metastatic nasopharyngeal carcinoma (NPC) treated with palliative chemotherapy and they thought that LDH seemed to be an important independent prognostic indicator for patients with disseminated NPC ( 6 ). In recent years, LAR as a new predictive indicator has been shown to be associated with the prognosis of many diseases, including stroke-associated pneumonia (SAP) ( 9 ), severe infection ( 10 ) and acute kidney injury ( 11 ).…”