Relationship Between the Lactate-to-Albumin Ratio and Acute Kidney Injury in Patients with Pulmonary Embolism: A Retrospective Cohort Study

TL;DR

This study shows that the lactate-to-albumin ratio (LAR) can predict acute kidney injury in patients with pulmonary embolism.

Contribution

This is the first study to examine the association between LAR and acute kidney injury in pulmonary embolism patients.

Findings

An LAR > 0.55 predicted AKI with 75% sensitivity and 67% specificity.

LAR was independently associated with AKI in patients with PE (OR: 6.334).

sPESI score and fibrinolytic therapy (tPA) were also independently linked to AKI.

Abstract

Background and Objectives: Pulmonary embolism (PE), the third most prevalent cause of cardiovascular death, is often regarded as a potentially fatal condition. Renal function has been shown to affect the short- and long-term prognosis of acute PE in several large registries. Therefore, the purpose of this study is to investigate the relationship between acute kidney injury (AKI) and the lactate-to-albumin ratio (LAR) in patients hospitalized for PE. Materials and Methods: 264 PE patients were included in this retrospective analysis. Based on the presence or absence of AKI, the study population was split into two groups. Results: Of the 264 patients included in our study, 161 (61%) were female. The median age was 67 ± 16 years. The sample was divided into two groups based on whether AKI developed (No AKI group, n = 176; AKI group, n = 88). A multivariate logistic regression analysis revealed that sPESI score, receiving fibrinolytic therapy (tPA), and LAR (OR: 6.334, 95% CI: 3.070–13.069; p < 0.001) were independently associated with AKI in patients with PE. In particular, an LAR > 0.55 predicted AKI in patients with PE, with a sensitivity of 75% and a specificity of 67% (AUC = 0.749, 95% CI = 0.692–0.800, p < 0.001). Conclusions: Our study demonstrates that the LAR independently predicts AKI in patients with PE. This is the first study that precisely examines this association in PE patients, as far as we are aware.

Figures