The correlation between serum inflammatory factors and rescue outcomes in critically ill patients with acute kidney injury

Fang Shunjin; Zhou Jie; Shen Jian

doi:10.3969/j.issn.1002-1949.2025.03.007

Abstract：Objective To investigate the correlation between serum inflammatory factors and rescue outcomes in critically ill patients with acute kidney injury.Methods The study included 203 cases of critically ill patients with acute kidney injury who were hospitalized in the Geriatrics Department of Huzhou Third People's Hospital from July 2021 to August 2024 as the research subjects.Based on their survival status within four weeks after admission,they were classified into survival group(n=151)and death group(n=52).A comparative analysis was conducted on the general clinical characteristics,peripheral blood inflammatory markers upon admission and serum inflammatory factor levels between the two groups.Both univariate and multivariate Logistic regression analyses were performed to assess the relationship between inflammatory-related indicators and the rescue outcomes of critically ill patients with acute kidney injury.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were employed to determine the predictive cutoff values and predictive effectiveness of each indicator for risk assessment.Furthermore,decision curve analysis and calibration curve were utilized to assess the predictive accuracy and effectiveness of joint prediction of various related factors for rescue outcomes of critically ill patients with acute kidney injury.Results Sequential organ failure assessment(SOFA),the levels of interleukin-6(IL-6),mean platelet volume/platelet count ratio(MPV/PLT),neutrophil/lymphocyte ratio(NLR),neutrophil/lymphocyte and platelet ratio(N/LPR),and systemic immune-inflammation index(SII)were found to be higher in the death group compared with the survival group(P＜0.05).Both univariate and multivariate Logistic regression analyses revealed a positive association of SOFA,IL-6,MPV/PLT and SII levels with the likelihood of rescue failure in critically ill patients with acute kidney injury(P＜0.05).The ROC curve analysis demonstrated that the combined use of SOFA,IL-6,MPV/PLT and SII had a predictive power with the AUC＞0.700,which indicated a reliable predictive value for identifying rescue failure in critically ill patients with acute kidney injury.Moreover,the calibration curve and decision curve analyses further confirmed the good calibration and net benefit of the model.Conclusions The relationship of rescue outcome with IL-6,MPV/PLT and SII in critically ill patients with acute kidney injury is significant.These parameters serve as valuable predictors for the outcomes of rescue efforts in critically ill patients with acute kidney injury.