Background: Lactate-to-albumin ratio (LAR) is an emergency predictive indicator of sepsis-related mortality. An elevated LAR is associated with poor outcomes in critically ill patients. However, its predictive value for acute kidney injury (AKI) in patients with sepsis remains unclear. Therefore, this study aimed to investigate the relationship between LAR and AKI in patients with sepsis.
Methods: The study population was derived from the Medical Information Mart for Intensive Care-IV (2.0) database and stratified into quartiles based on the LAR. The primary endpoint was the occurrence of AKI. The secondary endpoints were the use of renal replacement therapy (RRT) and in-hospital mortality. Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess the association between the LAR index and risk of AKI in patients with sepsis.
Results: In this study, 5,222 patients with sepsis were included, of whom 3,029 were male (58%). Kaplan-Meier survival analysis demonstrated significant differences in the cumulative incidence of AKI and cumulative usage rate of RRT among patients with sepsis based on the quartiles of the LAR index. Additionally, Cox proportional hazards analysis adjusted for confounding factors showed a significant association between the LAR index and incidence of AKI in patients with sepsis.
Conclusion: Our study indicated that a high LAR index can serve as an independent predictor of AKI in patients with sepsis.
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http://dx.doi.org/10.3389/fphys.2025.1469866 | DOI Listing |
BMJ Paediatr Open
March 2025
Children's Intensive Care Research Program, Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
Background: Sepsis affects 25 million children and neonates annually, causing significant mortality and morbidity. Early identification and treatment are crucial for improving outcomes. Identifying children at risk is challenging due to clinical heterogeneity and overlap with other conditions.
View Article and Find Full Text PDFPediatr Infect Dis J
March 2025
From the Department of Pediatrics.
Background: Critically ill children are at risk for subtherapeutic antibiotic concentrations. The frequency of target attainment and risk factors for subtherapeutic concentrations of cefepime in children have not been extensively studied.
Methods: We performed an observational study in critically ill children receiving a new prescription of standard dosing of cefepime for suspected sepsis (≥2 systemic inflammatory response syndrome criteria within 48 hours of cefepime start).
J Infect Dis
March 2025
Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France.
Background: Respiratory syncytial virus (RSV) is one of the deadliest respiratory viruses. There is a need to better identify prognostic factors in RSV-infected patients, particularly those requiring intensive care unit (ICU) admission, with a focus on immunosuppressed patients.
Methods: Multicenter, retrospective cohort study of RSV-infected adults hospitalized in 17 ICUs in the Great Paris area between 08/01/2017 and 05/01/2023.
J Immunol
January 2025
Program in Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada.
Macrophages are important mediators of immune responses with critical roles in the recognition and clearance of pathogens, as well as in the resolution of inflammation and wound healing. The neuronal guidance cue SLIT2 has been widely studied for its effects on immune cell functions, most notably directional cell migration. Recently, SLIT2 has been shown to directly enhance bacterial killing by macrophages, but the effects of SLIT2 on inflammatory activation of macrophages are less known.
View Article and Find Full Text PDFIndian J Gastroenterol
March 2025
Departments of Pediatrics, Giza, Egypt.
Background And Objectives: Kasai-portoenterostomy (KPE) is the initial attempt to restore the bile flow and salvage the native liver in biliary atresia (BA) patients. Cholangitis is a frequent complication after KPE and adequate treatment impacts the long-term outcome. The aim of our study is to assess the severity of cholangitis episodes in a cohort of BA patients post KPE, identify the causative agents, using several diagnostic methods, as well as to assess the tolerability and efficacy of our antimicrobial protocol.
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