Prognostic Value of Lactate/Albumin Ratio and NEWS-Lactate in Predicting Sepsis-Associated Acute Kidney Injury: A Retrospective Analysis
Archives of Academic Emergency Medicine,
Vol. 13 No. 1 (2025),
6 September 2025
,
Page e61
https://doi.org/10.22037/aaemj.v13i1.2723
Abstract
Introduction: Sepsis-associated acute kidney injury (SA-AKI) is a frequent complication in critically ill patients and is associated with increased mortality. This study aimed to evaluate the prognostic value of the lactate/albumin ratio (LAR) and other albumin-based biomarkers in predicting SA-AKI.
Methods: A retrospective observational study was conducted on 564 patients with sepsis, divided into two groups based on the presence (n = 298) or absence (n = 266) of AKI. Clinical characteristics, laboratory parameters, and disease severity scores (SOFA, APACHE II, NEWS, NEWS-Lactate) were compared between groups. The predictive performance of each marker in detecting SA-AKI was assessed using receiver operating characteristic (ROC) curve analysis.
Results: Patients with SA-AKI had significantly higher levels of lactate (p = 0.001), procalcitonin (PCT) (p = 0.001), urea (p = 0.019), creatinine (p = 0.004), and lower albumin (p = 0.001) concentrations upon admission. The LAR demonstrated the highest discriminative performance among all tested markers, with an area under the curve (AUC) of 0.800 (95% confidence interval (CI): 0.765–0.835), sensitivity of 70.5% (95% CI: 64.9 – 75.6), and specificity of 70.3% (95% CI: 64.4 – 75.7) at a cut-off value of 0.101. NEWS-Lactate also showed good prognostic ability (AUC = 0.772, 95% CI: 0.734–0.809), sensitivity of 71.1% (95% CI: 65.6 – 76.2), and specificity of 63.2% (95% CI: 57.1 – 69.0) at a cut-off value of 7.11. Other indices, including serum creatinine/albumin ratio (sCAR), blood urea nitrogen/albumin ratio (BAR), and procalcitonin/albumin ratio (PAR), and procalcitonin (PCT) × lactate, yielded moderate AUCs. While NEWS alone showed limited predictive value (AUC = 0.508), both SOFA and APACHE II scores were significantly higher in the SA-AKI group.
Conclusion: It seems that, the LAR and NEWS-Lactate are promising biomarkers for early detection of SA-AKI and may outperform conventional severity scores and standalone laboratory parameters.
- Acute kidney injury
- Prognosis
- Biomarkers
- Serum albumin
- Sepsis
- 2025-09-06 (2)
- 2025-07-01 (1)
How to Cite
References
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