Relationship between inflammatory-nutritional composite biomarkers and prognosis in patients with sepsis-associated acute kidney injury

Zeng Yong; Wang Shu; Zhao Jinchuan

doi:10.3760/j.issn.1673-4777.2026.05.014

Abstract：Objective To investigate the relationship between hemoglobin,albumin,lymphocyte and platelet(HALP)index,lactate dehydrogenase to albumin ratio(LAR),monocyte to high-density lipoprotein cholesterol ratio(MHR)and prognosis in patients with sepsis-associated acute kidney injury(S-AKI).Methods A total of 100 patients with S-AKI admitted to Chongqing Emergency Medical Center from May 2023 to May 2025 were retrospectively enrolled.According to 28 d survival status during hospitalization,patients were divided into survival group(52 cases)and death group(48 cases).Clinical data and laboratory data of the two groups were collected,HALP index,LAR and MHR were calculated.The factors associated with 28 d in-hospital mortality and the predictive value of HALP index,LAR and MHR for 28 d in-hospital mortality were analyzed.Results The proportion of stage 3 AKI,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,vasoactive drugs and mechanical ventilation in death group were higher than those in survival group(all P＜0.05).HALP index in death group was lower than that in survival group[(23.0±2.5)vs(27.6±3.1)](t=-8.112,P＜0.001),while LAR and MHR were higher than those in survival group[(12.0±2.2)vs(7.3±1.6),(14.3±3.7)vs(9.3±2.3)](t=12.283,8.188,both P＜0.001).Multivariate Logistic regression analysis showed that high SOFA score,stage 3 AKI,high LAR and high MHR were independent risk factors for 28 d in-hospital mortality in S-AKI patients(all P＜0.05),while high HALP index was a protective factor(P＜0.05).The area under the curve of HALP index,LAR and MHR for predicting 28 d in-hospital mortality in S-AKI patients was 0.746,0.729 and 0.750,respectively,and the combined prediction was 0.883,which was higher than that of each single indicator(all P＜0.05).Conclusion The combina-tion of HALP index,LAR and MHR can effectively predict the risk of adverse outcomes in patients with S-AKI.