Hematological Ratios Are Associated with Acute Kidney Injury and Mortality in Patients That Present with Suspected Infection at the Emergency Department

Abstract

The early recognition of acute kidney injury (AKI) is essential to improve outcomes and prevent complications such as chronic kidney disease, the need for renal-replacement therapy, and an increased length of hospital stay. Increasing evidence shows that inflammation plays an important role in the pathophysiology of AKI and mortality. Several inflammatory hematological ratios can be used to measure systemic inflammation. Therefore, the association between these ratios and outcomes (AKI and mortality) in patients suspected of having an infection at the emergency department was investigated. Data from the SPACE cohort were used. Cox regression was performed to investigate the association between seven hematological ratios and outcomes. A total of 1889 patients were included, of which 160 (8.5%) patients developed AKI and 102 (5.4%) died in <30 days. The Cox proportional-hazards model revealed that the neutrophil-to-lymphocyte ratio (NLR), segmented-neutrophil-to-monocyte ratio (SMR), and neutrophil-lymphocyte-platelet ratio (NLPR) are independently associated with AKI <30 days after emergency-department presentation. Additionally, the NLR, SMR and NLPR were associated with 30-day all-cause mortality. These findings are an important step forward for the early recognition of AKI. The use of these markers might enable emergency-department physicians to recognize and treat AKI in an early phase to potentially prevent complications.

Neutrophil-to-lymphocyte ratio versus platelet-to-lymphocyte ratio in predicting clinical outcomes in acute methanol poisoning

“…In corroboration, several studies correlated increased levels of the NLR, and other inflammatory ratios to the higher risk of development of acute kidney injury among critically ill patients. [55][56][57] Methanol may induce nephrotoxicity due to direct contributing factors, e.g., high blood methanol and formic acid levels, or indirect contributing factors, e.g., hemolysis and myoglobinuria. 58 In the same context, our study demonstrated that patients with the high NLR tertile had significantly higher blood methanol levels compared to low and intermediate NLR tertiles.…”

Frequency of acute renal injury in neonates with respiratory distress syndrome.

“…17,18 The associations with platelet count and leukocyte count may suggest that systemic inflammation plays a role in AKI and mortality in this population. 19,20 Relatively small sample sizes and single-center study designs are some of the limitations of this study. We only noted a relatively short-term outcome for children presenting with AKI.…”

Systemic Inflammation Markers Associated with Bone Mineral Density in perimenopausal and Postmenopausal Women

“…Neutrophil to lymphocyte*platelet ratio (NLPR) was reported as a promising predictor of acute kidney injury. 22 , 23 Further, Zinellu et al found that the aggregate index of systemic inflammation (AISI) can predict idiopathic pulmonary fibrosis mortality and guide patient management. 24 …”