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Abstract: TH-PO067

U-Shaped Association Between Platelet-to-Lymphocyte Ratio and In-Hospital Mortality in Critically Ill Patients With AKI Requiring Continuous Renal Replacement Therapy

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Noh, Hee Won, Kyungpook National University, Daegu, Korea (the Republic of)
  • Jeon, Soojee, Kyungpook National University, Daegu, Korea (the Republic of)
  • Jung, Hee-Yeon, Kyungpook National University, Daegu, Korea (the Republic of)
  • Choi, Ji-Young, Kyungpook National University, Daegu, Korea (the Republic of)
  • Park, Sun-Hee, Kyungpook National University, Daegu, Korea (the Republic of)
  • Kim, Chan-Duck, Kyungpook National University, Daegu, Korea (the Republic of)
  • Kim, Yong-Lim, Kyungpook National University, Daegu, Korea (the Republic of)
  • Lim, Jeong-Hoon, Kyungpook National University, Daegu, Korea (the Republic of)
  • Cho, Jang-Hee, Kyungpook National University, Daegu, Korea (the Republic of)
Background

The platelet-to-lymphocyte ratio (PLR) is a marker of inflammation and predictor of mortality in a variety of diseases. However, the effectiveness of PLR as a predictor of mortality in patients with severe acute kidney injury (AKI) is uncertain. We evaluated the association between PLR and mortality in critically ill patients with severe AKI who underwent continuous renal replacement therapy (CRRT).

Methods

This is a retrospective observational cohort study, and a total of 1044 patients with AKI who underwent CRRT in Kyungpook National University Hospital from 2017 to 2021 were analyzed. The study subjects were divided into quintiles according to the PLR at CRRT initiation. A Cox proportional hazards model was used to investigate the association between PLR and mortality.

Results

PLR was associated with in-hospital mortality in a non-linear manner, showing a higher mortality rate at both ends of the PLR. The Kaplan–Meier curve analysis revealed the highest mortality rates with the first and fifth quintiles, while the lowest mortality rate occurred with the third quintile. Compared with the third quintile (the lowest mortality rate group), the first (adjusted hazard ratio [aHR] = 1.94, 95% confidence interval [CI] = 1.44–2.62, P < 0.001) and fifth (aHR = 1.60, 95% CI = 1.18–2.18, P = 0.002) quintiles of PLR had significantly higher in-hospital mortality. The first and fifth quintiles showed a consistently increased risk of 30-day and 90-day mortality compared with the third quintile. In the subgroup analysis, lower and higher PLRs were predictors of in-hospital mortality in patients with older age, female sex, hypertension, diabetes, and higher Sequential Organ Failure Assessment score.

Conclusion

Both the lower and higher PLRs were independent predictors of in-hospital mortality in critically ill patients with AKI who underwent CRRT. Thus, the PLR may be a useful and easily accessible prognostic indicator for patients with severe AKI.

Funding

  • Government Support – Non-U.S.