Early Identification of Sepsis-Induced Acute Kidney Injury by Using Monocyte Distribution Width, Red-Blood-Cell Distribution, and Neutrophil-to-Lymphocyte Ratio
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Data Collection
2.2. Participants
2.3. Outcome Measures
2.4. Biomarker Measurement
2.5. Statistical Analysis
3. Results
3.1. Participant Characteristics
3.2. Univariate Logistic Regression
3.3. Multivariate Logistic Regression
3.4. ROC Curve and Area under the Curve
4. Discussion
- Sepsis-induced acute kidney injury (AKI) increases morbidity and mortality.
- An increase in blood cell anisocytosis is associated with sepsis-induced AKI.
- MDW is a novel biomarker for predicting sepsis-induced AKI.
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Non-AKI | AKI | p Value |
---|---|---|---|
(N = 159) | (N = 112) | ||
Age (years) | 73.00 (22.00) | 72.00 (23.00) | 0.322 |
Age subgroups N, (%) | 0.907 | ||
20–45 years | 14 (8.8%) | 12 (10.7%) | |
46–70 years | 54 (34.0%) | 40 (35.7%) | |
71–95 years | 86 (54.1%) | 56 (50.0%) | |
96–120 years | 5 (3.1%) | 4 (3.6%) | |
Sex, N (%) | 0.883 | ||
Female | 88 (55.3%) | 63 (56.3%) | |
Male | 71 (44.7%) | 49 (43.8%) | |
DM | 53 (33.3%) | 42 (37.5%) | 0.479 |
CKD | 141 (88.7%) | 102 (91.1%) | 0.524 |
Recent antibiotic use | 58 (36.5%) | 38 (33.9%) | 0.666 |
Recent contrast | 28 (17.6%) | 17 (15.2%) | 0.596 |
Recent NSAIDs use | 10 (6.3%) | 8 (7.1%) | 0.781 |
Recent ARB use | 41 (25.8%) | 39 (34.8%) | 0.108 |
Recent beta-blocker use | 51 (32.1%) | 35 (31.3%) | 0.886 |
Recent anti-PLT use | 41 (25.8%) | 27 (24.1%) | 0.754 |
Recent diuretics use | 34 (21.4%) | 24 (21.4%) | 0.993 |
MDW | 21.80 (7.00) | 26.20 (13.00) | <0.001 * |
RDW | 14.00 (2.90) | 15.00 (2.90) | 0.136 |
initial SOFA | 2.00 (2.00) | 3.00 (3.00) | 0.008 * |
MAP | 97.83 (26.20) | 86.00 (21.00) | <0.001 * |
NLR | 12.65 (13.23) | 14.55 (19.82) | 0.180 |
Variables | OR (95% CI) | p Value |
---|---|---|
MDW | 1.032 (1.012–1.061) | 0.003 |
RDW | 1.115 (1.025–1.212) | 0.011 |
initial SOFA | 1.283 (1.143–1.442) | <0.001 |
MAP | 0.975 (0.963–0.987) | <0.001 |
NLR | 1.014 (1.001–1.027) | 0.029 |
Age | 0.994 (0.980–1.009) | 0.427 |
Gender | 1.037 (0.637–1.688) | 0.883 |
DM | 0.833 (0.503–1.381) | 0.479 |
CKD | 0.768 (0.340–1.733) | 0.525 |
Recent antibiotic use | 0.894 (0.538–1.485) | 0.666 |
Recent contrast | 0.837 (0.434–1.617) | 0.597 |
Recent NSAIDs use | 1.146 (0.438–3.002) | 0.781 |
Recent ARB use | 0.650 (0.384–1.101) | 0.109 |
Recent beta-blocker use | 1.039 (0.618–1.748) | 0.886 |
Recent anti-PLT use | 1.094 (0.625–1.915) | 0.754 |
Recent diuretics use | 0.997 (0.553–1.798) | 0.993 |
Multivariate Analysis (Model 1) | Multivariate Analysis (Model 2) | Multivariate Analysis (Model 3) | ||||
---|---|---|---|---|---|---|
Variables | OR (95% CI) | p value | OR (95% CI) | p value | OR (95% CI) | p value |
MDW | 1.025 (1.001–1.050) | 0.044 | ||||
RDW | 1.070 (0.980–1.167) | 0.130 | ||||
initial SOFA | 1.202 (1.061–1.361) | 0.004 | 1.204 (1.063–1.364) | 0.004 | 1.212 (1.070–1.372) | 0.002 |
MAP | 0.982 (0.970–0.995) | 0.008 | 0.982 (0.969–0.994) | 0.005 | 0.982 (0.969–0.995) | 0.006 |
NLR | 1.010 (0.997–1.024) | 0.116 |
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Pan, Y.-H.; Tsai, H.-W.; Lin, H.-A.; Chen, C.-Y.; Chao, C.-C.; Lin, S.-F.; Hou, S.-K. Early Identification of Sepsis-Induced Acute Kidney Injury by Using Monocyte Distribution Width, Red-Blood-Cell Distribution, and Neutrophil-to-Lymphocyte Ratio. Diagnostics 2024, 14, 918. https://doi.org/10.3390/diagnostics14090918
Pan Y-H, Tsai H-W, Lin H-A, Chen C-Y, Chao C-C, Lin S-F, Hou S-K. Early Identification of Sepsis-Induced Acute Kidney Injury by Using Monocyte Distribution Width, Red-Blood-Cell Distribution, and Neutrophil-to-Lymphocyte Ratio. Diagnostics. 2024; 14(9):918. https://doi.org/10.3390/diagnostics14090918
Chicago/Turabian StylePan, Yi-Hsiang, Hung-Wei Tsai, Hui-An Lin, Ching-Yi Chen, Chun-Chieh Chao, Sheng-Feng Lin, and Sen-Kuang Hou. 2024. "Early Identification of Sepsis-Induced Acute Kidney Injury by Using Monocyte Distribution Width, Red-Blood-Cell Distribution, and Neutrophil-to-Lymphocyte Ratio" Diagnostics 14, no. 9: 918. https://doi.org/10.3390/diagnostics14090918