Renal tubular dysfunction and lactic acidosis: Questions

Kim, Siah; Curtin, Julie; Fleming, Jacqueline; Lewis, Deborah L.

doi:10.1007/s00467-012-2166-0

Cited by 1 publication

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“…However, lactate levels are also affected by other factors such as lactate clearance from the liver and aerobic glycolysis via Na-K ATPase [6]. Patients with diabetic ketoacidosis, renal dysfunction, metabolic disorders, tumors, and intoxication also develop lactic acidosis of varying degrees [7][8][9][10]. Non-pathogenic factors, such as some medications like epinephrine, metformin, and linezolid also can lead to elevated lactate levels.…”

Section: Introductionmentioning

confidence: 99%

Lactate/albumin ratio as a predictor of in-hospital mortality in critically ill children

Wang

Liu

et al. 2022

BMC Pediatr

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Objective Managing critically ill patients with high mortality can be difficult for clinicians in pediatric intensive care units (PICU), which need to identify appropriate predictive biomarkers. The lactate/albumin (L/A) ratio can precisely stratify critically ill adults. However, the role of the L/A ratio in predicting the outcomes of critically ill children remains unclear. Therefore, this study aimed to evaluate the prognostic performance of the L/A ratio in predicting in-hospital mortality in unselected critically ill patients in the PICU. Methods This was a single-center retrospective study. Clinical data of 8,832 critical patients aged between 28 days and 18 years were collected from the pediatric intensive care (PIC) database from 2010 to 2018. The primary outcome was the in-hospital mortality rate. Results There was a higher level of L/A ratio in non-survivors than survivors (P < 0.001). Logistic regression indicated that the association between the L/A ratio and in-hospital mortality was statistically significant (OR 1.44, 95% CI 1.31–1.59, P < 0.001). The AUROC of the L/A ratio for predicting in-hospital mortality was higher than lactate level alone (0.74 vs 0.70, P < 0.001). Stratification analysis showed a significant association between the L/A ratio and in-hospital mortality in the age and primary disease groups (P < 0.05). Conclusions Our study suggested that the L/A ratio was a clinical tool to predict in-hospital mortality in critically ill children better than lactate level alone. However, given that the study was retrospective, more prospective studies should be conducted to test the predictive value of the L/A ratio in critical illness.

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Section: Introductionmentioning

confidence: 99%