Prognostic value of fibrinogen to albumin ratios among critically ill patients with acute kidney injury

Xia, Wenqing; Li, Chenyu; Yao, Xiajuan; Chen, Yan; Yao-quan, Zhang; Hu, Hong

doi:10.1007/s11739-021-02898-3

Cited by 10 publications

(8 citation statements)

References 45 publications

(45 reference statements)

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“…As reported previously, elevated FPR and AFR better predict overall survival in various diseases than levels of albumin, pre‐albumin, and fibrinogen alone 10,14,15 . Indeed, despite plasma fibrinogen being the known component of the coagulation cascade, high fibrinogen levels were strongly associated with CVD mortality in inflammatory disorders by promoting the synthesis of proinflammatory cytokines 16,17 .…”

Section: Discussionmentioning

confidence: 72%

Elevated fibrinogen to pre‐albumin ratio predicts mortality in peritoneal dialysis patients

Xia

Hua

Sun

et al. 2023

Seminars in Dialysis

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AbstractbackgroundFibrinogen to pre‐albumin ratio (FPR) is a promising predictor of mortality in various cancers. The aim of this study was to explore the prognostic value of FPR to predict mortality in peritoneal dialysis (PD) patients.MethodsWe retrospectively analyzed 324 incident PD patients form January 2011 to December 2020. Patients were stratified based on the optimal thresholds for FPR at baseline to predict overall and cardiovascular mortality during follow‐up. The association of FPR and all‐cause and cardiovascular mortality was evaluated by Kaplan–Meier curve and Cox regression analysis.ResultsAll patients were divided into three groups based on the optimal cutoff value of FPR. Higher FPR levels were strongly correlated with worse overall and cardiovascular mortality in PD patients. Compared with patients in the lowest FPR tertile (<14.3), those in the highest terile (≥18.8) had multivariable‐adjusted hazard ratios (95% CI confidence interval) of 3.37 (1.76–6.49) and 2.86 (1.31–6.23) for all‐cause and cardiovascular mortality, respectively. Significant differences in overall survival were observed across nearly all subgroups after stratification.ConclusionsPatients with a high FPR had increased all‐cause and cardiovascular mortality. FPR is a potential prognostic indicator in PD patients.

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Section: Discussionmentioning

confidence: 72%

Elevated fibrinogen to pre‐albumin ratio predicts mortality in peritoneal dialysis patients

Xia

Hua

Sun

et al. 2023

Seminars in Dialysis

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“…LC-MS procedures have however not been established for clinical routine use on a daily basis yet. Xia and colleagues [16] finally analyzed the predictive role of the fibrinogen level to the albumin level ratio (FAR) in more than 5,000 critically ill AKI subjects. The FAR had been evaluated in other diseases also (e.g., malignant disorders [17][18][19], myocardial infarction [20]).…”

Section: Discussionmentioning

confidence: 99%

Increased Serum Sodium at Acute Kidney Injury Onset Predicts In-Hospital Death

et al. 2023

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Background: Over the last decades, acute kidney injury (AKI) has been identified as a potentially fatal diagnosis which substantially increases in-hospital mortality in the short term and morbidity/mortality in the long term. However, reliable biomarkers for predicting AKI-associated outcomes are still missing. In this study, we assessed whether serum sodium, measured at different time points during the in-hospital treatment period, provided prognostic information in AKI.Methods: This was a retrospective, observational cohort study. AKI subjects were identified via the in-hospital AKI alert system. Serum sodium and potassium levels were documented at five pre-defined time points: hospital admission, AKI onset, minimum estimated glomerular filtration rate, minimum and maximum of the respective electrolyte during the treatment period. In-hospital death, the need for kidney replacement therapy (KRT) and recovery of kidney function were defined as endpoints.Results: Patients who suffered in-hospital death (n = 37, 23.1%) showed significantly higher serum sodium levels at diagnosis of AKI (survivors: 145.7 ± 2.13 vs. non-survivors: 138.8 ± 0.636 mmol/L, P = 0.003). A logistic regression model was significant for serum sodium levels in patients with in-hospital death (X 2 , P = 0.003; odds ratio = 1.08 (1.022 -1.141); R 2 = 0.082; d = 0.089). This suggests an increase of the relative risk for in-hospital death by 8% with every unit of serum sodium increase. Patients with a sodium above the upper normal range at AKI diagnosis were also more likely to suffer in-hospital death (P = 0.001). Conclusion:In summary, we present evidence that serum sodium, measured at time of AKI diagnosis, potentially serves as a predictor for in-hospital death in patients with AKI.

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“…The problem with such an approach is often the lack of control groups and/or the lack of comparisons with other, already established AKI biomarkers. For instance, the following biomarkers have been shown to predict the mortality risk in AKI: NGAL, KIM-1 (both [ 43 ]), the fibrinogen-to-albumin ratio (FAR) [ 44 ], soluble suppression of tumorigenicity 2 (sST2) (circulating interleukin (IL)-33 receptor isoform [ 45 ]), and certain panels of metabolites [ 46 ]. A 2020 published study by Fiorentino [ 47 ] on the other hand identified urinary (TIMP-2) • (IGFBP7) (tissue metalloproteinase-2 and insulin-like growth factor-binding protein-7) of > 0.3 as dialysis predictive in septic AKI individuals.…”

Section: Discussionmentioning

confidence: 99%

Stratification of Acute Kidney Injury Risk, Disease Severity, and Outcomes by Electrolyte Disturbances

et al. 2023

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Acute kidney injury (AKI) affects up to 30% of all hospitalized patients in Central Europe and the USA. New biomarker molecules have been identified in recent years; most studies performed so far however aimed to identify markers for diagnostic purposes. Serum electrolytes such as sodium and potassium are quantified in more or less all hospitalized patients. Aim of the article is to review the literature on the AKI predictive role of four distinct serum electrolytes in evolving/progressing AKI. The following databases were searched for references: PubMed, Web of Science, Cochrane Library, and Scopus. The period lasted from 2010 until 2022. The following terms were utilized: "AKI" AND "sodium" OR "potassium" OR "calcium" OR "phosphate" AND "risk" OR "dialysis" OR "recovery of kidney function" OR "renal recovery" OR "kidney recovery" OR "outcome". Finally, 17 references were selected. The included studies were mostly retrospective in nature. Particularly, hyponatremia has been shown to be associated with an overall poor clinical outcome. The association between dysnatremia and AKI is anything but consistent. Hyperkalemia and potassium variability are most likely AKI predictive. Serum calcium and AKI risk are associated in a Ushaped manner. Higher phosphate levels potentially predict AKI in non-coronavirus disease 2019 (COVID-19) patients. The literature suggests that admission electrolytes can offer valuable information about AKI onset during follow-up. Limited data are however available on follow-up characteristics such as the need for dialysis or the chance of renal recovery. These aspects are of particular interest from the nephrologist's perspective.

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Prognostic value of fibrinogen to albumin ratios among critically ill patients with acute kidney injury

Cited by 10 publications

References 45 publications

Elevated fibrinogen to pre‐albumin ratio predicts mortality in peritoneal dialysis patients

Elevated fibrinogen to pre‐albumin ratio predicts mortality in peritoneal dialysis patients

Increased Serum Sodium at Acute Kidney Injury Onset Predicts In-Hospital Death

Stratification of Acute Kidney Injury Risk, Disease Severity, and Outcomes by Electrolyte Disturbances

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