The value of melatonin-to-procalcitonin ratio in predicting the risk of acute kidney injury and its association with short-term survival in sepsis patients
YUAN Yuan
HUANG Peiyong
LIU Shulin
YUAN Yuting
Abstract：Objective To analyze the value of melatonin-to-procalcitonin ratio(MLT/PCT)in predicting the risk of acute kidney injury(AKI)and its association with short-term survival in sepsis patients.Methods A total of 110 patients with sepsis who were admitted to Chongqin Jiangjin Second People's Hospital from January 2021 to December 2023 were recruited.The patients were divided into AKI group(49 cases)and non-AKI group(61 cases)according to the occurrence of AKI.The patients were divided into survival group(74 cases)and death group(36 cases)according to their survival status within 28 days.On the second day after admission,the serum procalcitonin(PCT)levels were detected by using electrochemiluminescence immunoassay,and the serum melatonin(MLT)levels were detected by using enzyme-linked immunosorbent assay(ELISA),and MLT/PCT was calculated.Multivariate logistic regression was used to analyze the influencing factors of AKI in patients with sepsis.The predictive efficacy of MLT,PCT and MLT/PCT for AKI in the patients with sepsis was analyzed by using receiver operating characteristic(ROC)curve.Kaplan-Meier method was used to analyze the association between MLT/PCT and the patients'survival prognosis.Results The patients in the AKI group were older than those in the non-AKI group,and the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores,proportion of hypertensive patients,white blood cell count,neutrophil percentage,alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin,serum creatinine,urea nitrogen,blood lactate and PCT levels in the AKI group were higher than those in the non-AKI group,and the percentage of lymphocytes,red blood cell count,platelet count,blood pH,MLT levels and MLT/PCT in the AKI group were lower than those in the non-AKI group,and the differences were statistically significant(P＜0.05).The results of ROC curve analysis showed that MLT/PCT[AUC(95％CI)=0.920(0.853-0.963)]was superior to MLT and PCT(P＜0.05)in predicting AKI occurrence in the sepsis patients,with sensitivity of 93.92％and specificity of 75.38％.The results of multivariate logistic regression analysis showed that higher MLT/PCT was an independent protective factor for AKI in sepsis patients(P＜0.05).The MLT levels and MLT/PCT in the survival group were significantly higher than those in the death group(P＜0.05).The survival prognosis of the high MLT/PCT group(≥3.3,55 cases)was better than that of the low MLT/PCT group(＜3.3,55 cases)(log-rank test:x2=23.627,P＜0.001).Conclusion MLT/PCT can be used as an indicator to predict the risk of AKI in sepsis patients,and MLT/PCT is associated with short-term survival prognosis of the sepsis patients.
Keywords：SepsisAcute kidney injury(AKI)Melatonin(MLT)Procalcitonin(PCT)Prognosis
Publication Date：2025-02-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 200-205 )