# Early lactate and its metabolism for predicting persistent renal failure in patients with acute pancreatitis: a retrospective observational study

## TL;DR

High levels of lactate and lactate dehydrogenase in early stages of acute pancreatitis predict kidney failure risk.

## Contribution

Identifies lactate and LDH as early predictors of persistent renal failure in acute pancreatitis patients.

## Key findings

- Lactate and LDH levels within 24 hours of admission are significant risk factors for persistent renal failure.
- Combined lactate and LDH indicators show highest diagnostic accuracy (AUC of 0.866) for predicting PRF.
- High-risk patients with elevated lactate and LDH have significantly higher PRF incidence than low-risk patients.

## Abstract

Acute pancreatitis (AP) is common and clinically complex, and persistent renal failure (PRF) is a severe complication. This study retrospectively analyzed 798 AP patients admitted within three days of onset and divided them into a PRF group (n = 111) and a non-PRF group (n = 687), comparing the characteristics of the two groups. Multivariate analysis showed that lactate (β = 0.340, P < 0.001, OR = 1.405) and lactate dehydrogenase (LDH, β = 0.002, P < 0.001, OR = 1.002) were significant risk factors for PRF. Stratified analysis indicated that patients with LDH ≥ 700 U/L and lactate ≥ 2 mmol/L had a higher incidence of PRF. The ROC curve analysis showed that the areas under the curve for lactate, LDH, and the combined lactate + LDH were 0.752, 0.828, and 0.866, respectively, with the highest diagnostic accuracy for the combined indicator. The characteristics of different risk groups showed that the incidence of PRF in the high-risk group was significantly higher than that in the low-risk group. The levels of lactate and LDH within 24 h of admission have a significant predictive effect on PRF in AP patients, which helps clinicians identify high-risk patients early and guide treatment decisions.