Wenkai Xia1,2, Danyang Zhao2, Chenyu Li2, Lingyu Xu3, Xiajuan Yao1, Hong Hu4. 1. Department of Nephrology, Jiangyin People's Hospital Affiliated to Nantong University, 3 Yinrui Road, Jiangyin, 214400, Jiangsu, China. 2. Nephrologisches Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany. 3. Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China. 4. Department of Nephrology, Jiangyin People's Hospital Affiliated to Nantong University, 3 Yinrui Road, Jiangyin, 214400, Jiangsu, China. huhong1523@163.com.
Abstract
OBJECTIVE: No epidemiological evidence has investigated the effect of albumin to alkaline phosphatase ratio (AAPR) on the prognosis among critically ill patients with acute kidney injury (AKI). We aimed to explore the prognostic value of AAPR in these patients. METHODS: We extracted all clinical data from MIMIC III. ROC curve analysis was used to evaluate the discrimination of AAPR for predicting in-hospital mortality. A generalized additive model was applied to identify a nonlinear association between AAPR and in-hospital mortality. The Cox proportional hazards models were used to determine the association between AAPR and in-hospital and 30-day mortality. RESULTS: A total of 6894 eligible subjects were enrolled in this study. The relationship between AAPR and in-hospital mortality was nonlinear. Multivariate analysis demonstrated that lower AAPR (AAPR < 0.35) was an independent predictor of in-hospital and 30-day mortality after adjusting for potential confounders (HR 1.74, 95% CI 1.72-2.20, P < 0.001; HR 1.89, 95% CI 1.66-2.14, P < 0.001, respectively). CONCLUSIONS: AAPR may serve as a potential prognostic biomarker in critically ill patients with AKI and lower AAPR was associated with increased risk of in-hospital and 30-day mortality among these patients.
OBJECTIVE: No epidemiological evidence has investigated the effect of albumin to alkaline phosphatase ratio (AAPR) on the prognosis among critically ill patients with acute kidney injury (AKI). We aimed to explore the prognostic value of AAPR in these patients. METHODS: We extracted all clinical data from MIMIC III. ROC curve analysis was used to evaluate the discrimination of AAPR for predicting in-hospital mortality. A generalized additive model was applied to identify a nonlinear association between AAPR and in-hospital mortality. The Cox proportional hazards models were used to determine the association between AAPR and in-hospital and 30-day mortality. RESULTS: A total of 6894 eligible subjects were enrolled in this study. The relationship between AAPR and in-hospital mortality was nonlinear. Multivariate analysis demonstrated that lower AAPR (AAPR < 0.35) was an independent predictor of in-hospital and 30-day mortality after adjusting for potential confounders (HR 1.74, 95% CI 1.72-2.20, P < 0.001; HR 1.89, 95% CI 1.66-2.14, P < 0.001, respectively). CONCLUSIONS: AAPR may serve as a potential prognostic biomarker in critically ill patients with AKI and lower AAPR was associated with increased risk of in-hospital and 30-day mortality among these patients.
Authors: Philippe Lachance; Pierre-Marc Villeneuve; Oleksa G Rewa; Francis P Wilson; Nicholas M Selby; Robin M Featherstone; Sean M Bagshaw Journal: Nephrol Dial Transplant Date: 2017-02-01 Impact factor: 5.992
Authors: Aditya Biswas; Chirag R Parikh; Harold I Feldman; Amit X Garg; Stephen Latham; Haiqun Lin; Paul M Palevsky; Ugochukwu Ugwuowo; F Perry Wilson Journal: Clin J Am Soc Nephrol Date: 2018-03-29 Impact factor: 8.237