Clinical Value of Prognostic Nutritional Index and Neutrophil-to-Lymphocyte Ratio in Prediction of the Development of Sepsis-Induced Kidney Injury

Xie, Tonghui; Xin, Qi; Chen, Rui; Zhang, Xing; Zhang, Fengping; Ren, Hong; Liu, Chang; Zhang, Jingyao

doi:10.1155/2022/1449758

Cited by 11 publications

(8 citation statements)

References 40 publications

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“…CRP, PCT dan NLR berkorelasi signifikan dengan kadar kreatinin (p<0,001); PCT menunjukkan koefisien korelasi tertinggi (r=0,414), sedangkan MAP menunjukkan korelasi yang lebih lemah (r=0,044). 29 Harjana et al melihat perbedaan nilai NLR dan serum sydencan-1 pada jam ke-1, 6, dan 24 pada pasien AKI sepsis, didapatkan nilai NLR pada jam tersebut lebih tinggi pada kelompok AKI sepsis dibandingkan dengan pasien non AKI (jam ke-1: 33,0±11,3 vs 15,9±2,6; jam ke-6: 19,3±3,8 vs 14,2±1,8; dan jam ke-24: 19,9±3,8 vs 11,6±1,3) (p <0,00). 31 Prado et al pada studinya untuk mengetahui peran NLR dalam memprediksi kejadian AKI pada 125 pasien sepsis di ICU menunjukkan signifikansi NLR dalam mendeteksi AKI dan jika dikaitkan dengan nilai klinis, kelompok dengan nilai NLR tinggi yaitu median 32,6 memiliki LOS yang lebih panjang.…”

Section: Analisis Perubahan Nilai Nlr Pada Kelompok Akiunclassified

Hubungan Neutrophil-Lymphocyte Ratio dengan Kejadian Acute Kidney Injury Pada Pasien Sepsis yang Dirawat di Intensive Care Unit (ICU)

Jaelani,

Arif,

Muchtar

et al. 2023

MACC

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Latar Belakang: Gagal Ginjal Akut (Acute Kidney Injury/AKI) adalah salah satu komplikasi yang umum dijumpai pada pasien dengan penyakit kritis di unit perawatan intensif (ICU). AKI merupakan komplikasi utama dari sepsis dan syok sepsis. Neutrophil-to-Lymphocyte Ratio (NLR) adalah penanda pengganti untuk respon inflamasi sistemik yang tersedia secara luas dan murah. Studi mengenai nilai diagnostik NLR dalam mendeteksi kejadian AKI masih terbatas dan hanya sedikit diketahui nilai klinis NLR terhadap pasien AKI sepsis. Tujuan: Mengetahui hubungan antara NLR dengan kejadian AKI pada pasien sepsis yang menjalani perawatan di ICU. Subjek dan Metode: Metode kohort retrospektif diaplikasikan dalam penelitian ini terhadap 80 pasien sepsis yang dirawat di ICU RSUP Dr. Wahidin Sudirohusodo (RSWS) Makassar sejak Januari 2019 – Desember 2021 yang dibagi dalam 40 sampel kelompok AKI dan 40 sampel non AKI. Sampel dikumpulkan dari data rekam medik pasien selama bulan Juli – September 2022. SPSS 25.0 dipakai untuk mengenalisis data dengan pengujian statistik Mann-Whitney, Chi-Square dengan level signifikansi α=0,05 dan analisis Kurva ROC. Hasil: Ditemukan perbedaan yang signifikan dari nilai NLR dan kadar kreatinin hari pertama dan ketiga pada kelompok AKI dan non-AKI (p<0.001). Terdapat penurunan nilai NLR yang signifikan jika dibandingkan antara hari pertama dan ketiga pada Kelompok AKI dengan nilai p= 0.001. Pada hari pertama dan ketiga terdapat korelasi antara nilai NLR dan kejadian AKI dengan hubungan linier sedang (r=0.577 dan r=0.534, berurutan). Uji ROC Curve dan Youden Index menunjukkan nilai cut off NLR untuk dapat memprediksi AKI yakni 15.15 dengan sensitivitas 70% dan spesifisitas 90%. Simpulan: Nilai NLR yang diukur pada 24 jam saat masuk ICU dapat menjadi prediktor terjadinya AKI sepsis, sehingga dapat dimasukkan dalam pemeriksaan rutin untuk deteksi dini terjadinya AKI sepsis pada penderita sepsis yang menjalani perawatan di ICU.

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Section: Analisis Perubahan Nilai Nlr Pada Kelompok Akiunclassified

Hubungan Neutrophil-Lymphocyte Ratio dengan Kejadian Acute Kidney Injury Pada Pasien Sepsis yang Dirawat di Intensive Care Unit (ICU)

Jaelani,

Arif,

Muchtar

et al. 2023

MACC

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“…On the one hand, several novel biomarkers had been developed to improve diagnostic sensitivity and specificity of SA-AKI. Frustratingly, these biomarkers mostly are prohibitively expensive for widespread clinical use [ 6 ]. On the other hand, some researchers have established predictive models for AKI in septic patients.…”

Section: Introductionmentioning

confidence: 99%

Development and external validation of a nomogram for the early prediction of acute kidney injury in septic patients: a multicenter retrospective clinical study

Su,

Chen,

Zheng

et al. 2024

Renal Failure

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Background and purpose: Acute kidney injury (AKI) is a common serious complication in sepsis patients with a high mortality rate. This study aimed to develop and validate a predictive model for sepsis associated acute kidney injury (SA-AKI). Methods: In our study, we retrospectively constructed a development cohort comprising 733 septic patients admitted to eight Grade-A tertiary hospitals in Shanghai from January 2021 to October 2022. Additionally, we established an external validation cohort consisting of 336 septic patients admitted to our hospital from January 2017 to December 2019. Risk predictors were selected by LASSO regression, and a corresponding nomogram was constructed. We evaluated the model’s discrimination, precision and clinical benefit through receiver operating characteristic (ROC) curves, calibration plots, decision curve analysis (DCA) and clinical impact curves (CIC) in both internal and external validation. Results: AKI incidence was 53.2% in the development cohort and 48.2% in the external validation cohort. The model included five independent indicators: chronic kidney disease stages 1 to 3, blood urea nitrogen, procalcitonin, D-dimer and creatine kinase isoenzyme. The AUC of the model in the development and validation cohorts was 0.914 (95% CI, 0.894–0.934) and 0.923 (95% CI, 0.895–0.952), respectively. The calibration plot, DCA, and CIC demonstrated the model’s favorable clinical applicability. Conclusion: We developed and validated a robust nomogram model, which might identify patients at risk of SA-AKI and promising for clinical applications.

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“…Several studies have suggested that PNI is a reliable biomarker for predicting early prognosis in patients with malignant tumors (18,19). In addition, previous studies have demonstrated that PNI or NLR is a biomarker for predicting survival and mortality rates of patients with sepsis-induced acute kidney injury (AKI) (20,21). In addition, procalcitonin (PCT) and C-reactive protein (CRP) are known to be used to diagnose sepsis and predict its severity and mortality in patients (22,23).…”

Section: Introductionmentioning

confidence: 99%

Clinical value of neutrophil-to-lymphocyte ratio and prognostic nutritional index on prediction of occurrence and development of diabetic foot-induced sepsis

Sun,

Chen,

Man

et al. 2023

Front. Public Health

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BackgroundDiabetic foot-induced sepsis is a serious complication associated with increased disability and mortality in hospitalized patients. Early prediction of admission and detection effectively improve treatment options and prevent further deterioration. This study aims to evaluate the clinical value of the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI) to predict the risk of sepsis in patients with diabetic foot ulcers (DFU).MethodsRetrospective analysis was performed on 216 patients who were admitted to the Fujian Medical University Union Hospital between January 2015 and December 2022. Patients with DFU were divided into the non-sepsis (n = 166) and the DFU-induced sepsis (n = 50) groups. The independent factors of DFU-induced sepsis were determined by univariate and multivariate logistic regression analyses. A receiver operating characteristic (ROC) curve was performed to compare the area under the curves (AUC) of PNI and NLR.ResultsMultivariate logistic regression analysis revealed that the PNI, NLR, international normalized ratio (INR), thrombin time (PT), and C-reactive protein (CRP) were independent prognostic factors for DFU-induced sepsis. After adjusting for potential confounders, the adjusted odds ratios of NLR for DFU-induced sepsis were 1.121 (1.072–1.172), 1.132 (1.077–1.189), and 1.080 (1.022–1.142), while those of PNI were 0.912 (0.873–0.953), 0.902 (0.856–0.950), and 1.004 (1.001–1.006). Moreover, the AUC of NLR was significantly greater than that of CRP (0.790, 95% CI: 0.689–0.891, p < 0.001 vs. 0.780, 95% CI: 0.686–0.873, p < 0.001).ConclusionNLR and PNI have been regarded as readily and independently predictive markers in patients with DFU-induced sepsis. NLR is critical for the early detection and effective treatment of DFU-induced sepsis and is superior to CRP.

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Clinical Value of Prognostic Nutritional Index and Neutrophil-to-Lymphocyte Ratio in Prediction of the Development of Sepsis-Induced Kidney Injury

Cited by 11 publications

References 40 publications

Hubungan Neutrophil-Lymphocyte Ratio dengan Kejadian Acute Kidney Injury Pada Pasien Sepsis yang Dirawat di Intensive Care Unit (ICU)

Hubungan Neutrophil-Lymphocyte Ratio dengan Kejadian Acute Kidney Injury Pada Pasien Sepsis yang Dirawat di Intensive Care Unit (ICU)

Development and external validation of a nomogram for the early prediction of acute kidney injury in septic patients: a multicenter retrospective clinical study

Clinical value of neutrophil-to-lymphocyte ratio and prognostic nutritional index on prediction of occurrence and development of diabetic foot-induced sepsis

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