Abstract: SA-PO077

Utilizing CBC to Predict AKI and Its Recovery

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Khan, Asif, Staten Island University Hospital, Brooklyn, New York, United States
  • Gutman, Anna Sheina, Northwell Health, Brooklyn, New York, United States
  • El-Charabaty, Elie, Staten Island University Hospital, Brooklyn, New York, United States
  • El Sayegh, Suzanne E., Staten Island University Hospital, Brooklyn, New York, United States
Background

The difficulty in diagnosing acute kidney injury (AKI) prior to an elevation of serum creatinine, or a decrease in urine output, continues to pose challenges for nephrologists. Multiple new biomarkers of kidney damage have been evaluated, but their clinical value remains limited. The value of the neutrophil to lymphocyte ratio (NLR) is an indicator of systemic inflammation, which is easily calculated from a CBC. We investigated the hypothesis that a high NLR may predict the development of AKI.

Methods

This retrospective study identified patients of 18 years and older. We compared the NLR trends between patients with pneumonia and AKI as the experimental group (PAAG), to patients with pneumonia without AKI as the control group (PWAG). Day 0 was labeled as the day of AKI diagnosis, and the day of pneumonia diagnosis in the PAAG and the PWAG respectively. We documented trends of NLR and kidney function from 3 days before Day 0 until 3 days after Day 0.

Results

Of the 222 patients enrolled, 115 were in the PAAG, and 107 in the PWAG. Both groups had similar percentages of sexes, ethnicities, underlying hypertension, coronary artery disease, heart failure, and a similar median age. The PAAG had a significantly higher number of patients with chronic kidney disease and diabetes mellitus compared to the PWAG (47.9% vs. 4.8% (P<0.001) for CKD, and 40.4% vs. 24.1% (p=0.02) for DM).

There was an increase in the mean NLR from day -3 to day 0 of 12.4 in the PAAG, and only a 0.6 in the PWAG group. These results suggest a positive correlation between a certain net change in NLR and the development of AKI.

Conclusion

The potential of NLR as an indicator of systemic inflammation is well established. A timely use of NLR within twenty-four hours of admission may predict an impending AKI. Further studies are necessary to establish the trends in NLR prior to the diagnosis of AKI.

Graph showing the trends in NLR in the PAAG compared to the PWAG, and trends in the serum creatinine of both groups.