Neutrophil-to-lymphocyte ratio is a marker for acute kidney injury progression and mortality in critically ill populations: a population-based, multi-institutional study View Full Text


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Article Info

DATE

2021-10-08

AUTHORS

Jia-Jin Chen, George Kuo, Pei-Chun Fan, Tao-Han Lee, Chieh-Li Yen, Cheng-Chia Lee, Ya-Chung Tian, Chih-Hsiang Chang

ABSTRACT

BACKGROUNDS: Neutrophil-to-lymphocyte ratio (NLR), a surrogate marker of systemic response to physiological stress, is used for prognosis prediction in many diseases. However, the usefulness of this marker for predicting acute kidney injury (AKI) progression is unclear. METHODS: This retrospective study was based on the Chang Gung Research Database. Patients admitted to the intensive care unit with a diagnosis of stage 1 or 2 AKI were identified. The primary outcome was a composite of progression to stage 3 AKI, requirement of renal replacement therapy, or 14-day in-hospital mortality. The association between NLR and the primary outcome was examined using a logistic regression model and multivariable analysis. The nonlinearity and cutoff points of this relationship were determined using a restricted cubic spline model. RESULTS: A total of 10,441 patients were enrolled. NLR level at the time of stage 1-2 AKI diagnosis was a marker of adverse outcomes. After adjustment for confounders, NLR was independently associated with the composite outcome of AKI progression, renal replacement therapy, or mortality. The restricted cubic spline model revealed a J-shaped curve, with the lowest odds ratio for an NLR between 7 and 38. Subgroup analysis revealed linear and J-shaped relationships between NLR and the primary outcome in patients admitted to the intensive care unit for medical reasons and for cardiovascular surgery, respectively. CONCLUSIONS: NLR is an independent marker of AKI progression and in-hospital mortality. Because it is readily available in daily practice, it might be used for risk stratification in the AKI population. More... »

PAGES

1-10

References to SciGraph publications

  • 2018-03-14. Biomarkers for prediction of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis in INTENSIVE CARE MEDICINE
  • 2019-03-15. Neutrophil-to-lymphocyte ratio and incident end-stage renal disease in Chinese patients with chronic kidney disease: results from the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) in JOURNAL OF TRANSLATIONAL MEDICINE
  • 2016-03-15. Creatinine-based definitions: from baseline creatinine to serum creatinine adjustment in intensive care in CRITICAL CARE
  • 2017-09-08. Prognostic value of platelet-to-lymphocyte ratios among critically ill patients with acute kidney injury in CRITICAL CARE
  • 2017-09-06. The utility of neutrophil to lymphocyte ratio and fluid sequestration as an early predictor of severe acute pancreatitis in SCIENTIFIC REPORTS
  • 2016-02-16. Diagnosis and prognosis of neutrophil gelatinase-associated lipocalin for acute kidney injury with sepsis: a systematic review and meta-analysis in CRITICAL CARE
  • 2013-09-20. Development and Standardization of a Furosemide Stress Test to Predict the Severity of Acute Kidney Injury in CRITICAL CARE
  • 2015-12-01. The association between the neutrophil-to-lymphocyte ratio and mortality in critical illness: an observational cohort study in CRITICAL CARE
  • 2017-07-29. Single emergency room measurement of neutrophil/lymphocyte ratio for early detection of acute kidney injury (AKI) in INTERNAL AND EMERGENCY MEDICINE
  • 2017-11-28. Acute kidney injury based on the KDIGO criteria among ST elevation myocardial infarction patients treated by primary percutaneous intervention in JOURNAL OF NEPHROLOGY
  • 2017-03-25. Diagnostic value of urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor binding protein 7 for acute kidney injury: a meta-analysis in CRITICAL CARE
  • 2020-05-07. Furosemide stress test as a predictive marker of acute kidney injury progression or renal replacement therapy: a systemic review and meta-analysis in CRITICAL CARE
  • 2015-09-28. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Oncologic Outcomes of Esophageal Cancer: A Systematic Review and Meta-analysis in ANNALS OF SURGICAL ONCOLOGY
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    URI

    http://scigraph.springernature.com/pub.10.1007/s40620-021-01162-3

    DOI

    http://dx.doi.org/10.1007/s40620-021-01162-3

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1141724499

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34623629


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