Monocytes to lymphocytes multiplying platelets ratio as an early indicator of acute kidney injury in cardiac surgery with cardiopulmonary bypass: a retrospective analysis.

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-06-24 DOI:10.1080/0886022X.2024.2364776
Qian Li, Hong Lv, Yuye Chen, Jingjia Shen, Jia Shi, Fuxia Yan, Sheng Wang, Chenghui Zhou
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Abstract

Objective: The monocyte-to-lymphocyte multiplying platelets ratio (MLPR) is a novel systemic inflammatory marker, deriving from the monocyte-to-lymphocyte ratio (MLR). However, the link between MLPR and acute kidney injury following cardiac surgery (CSA-AKI) with cardiopulmonary bypass (CPB) has not been investigated yet. We comprehensively explored the potential linear and nonlinear relationship between MLPR or MLR and CSA-AKI.

Methods: Data of patients who underwent cardiac surgery with CPB between December 2018 and April 2021 were retrospectively collected at Fuwai Hospital, Beijing, China. MLPR was defined as monocyte count (×109/L) × 1000/(lymphocyte count (×109/L) × platelets (×109/L)). MLR was defined as monocyte count (×109/L)/lymphocyte count (×109/L). Logistic regression and restricted cubic spline (RCS) were used for linear and nonlinear analysis. The primary outcome was postoperative AKI within 48 h of after cardiac surgery.

Results: Of the 2420 patients screened, 2387 eligible patients were enrolled in the final analysis; the mean age was 54.7 years, and 1501 [62.9%] were men. The incidence of AKI was 25.8%. Logistic regression showed that MLPR (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.16-1.48, p < .001) and MLR (OR = 3.06, 95% CI: 1.29-7.29, p = .012) were independent risk factors for AKI. Moreover, in the RCS model with adjustment for age (median: 56), female sex, and history of diabetes, a significant statistical difference was detected between preoperative MLPR, MLR, and AKI (p for non-linearity <.001). The subgroup analyses revealed similar results.

Conclusions: The study revealed a nonlinear relationship between MLPR and MLR with AKI. MLPR exhibited a J-shaped curve, and MLR showed a favorable S-shaped curve in relation to AKI. Particularly, MLPR emerges as a promising clinical composite index for early CSA-AKI prediction. These findings emphasize the significance of MLPR as a valuable tool in clinical practice for timely identification and management of CSA-AKI.

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单核细胞与淋巴细胞增殖血小板比率作为心肺旁路心脏手术急性肾损伤的早期指标:一项回顾性分析。
目的:单核细胞与淋巴细胞血小板乘积比(MLPR)是一种新型的全身炎症标志物,源自单核细胞与淋巴细胞比值(MLR)。然而,MLPR 与心肺旁路(CPB)心脏手术后急性肾损伤(CSA-AKI)之间的联系尚未得到研究。我们全面探讨了 MLPR 或 MLR 与 CSA-AKI 之间潜在的线性和非线性关系:回顾性收集中国北京阜外医院 2018 年 12 月至 2021 年 4 月期间接受 CPB 心脏手术的患者数据。MLPR定义为单核细胞计数(×109/L)×1000/(淋巴细胞计数(×109/L)×血小板(×109/L))。MLR定义为单核细胞计数(×109/L)/淋巴细胞计数(×109/L)。线性和非线性分析采用逻辑回归和受限立方样条曲线(RCS)。主要结果是心脏手术后 48 小时内的术后 AKI:在筛选出的 2420 名患者中,有 2387 名符合条件的患者被纳入最终分析;平均年龄为 54.7 岁,男性患者有 1501 人[62.9%]。AKI 发生率为 25.8%。逻辑回归显示,MLPR(几率比 [OR] = 1.31,95% 置信区间 [CI]:1.16-1.48,P = .012)是导致 AKI 的独立风险因素。此外,在调整了年龄(中位数:56)、女性性别和糖尿病史的 RCS 模型中,发现术前 MLPR、MLR 和 AKI 之间存在显著的统计学差异(P 为非线性结论):研究显示,MLPR 和 MLR 与 AKI 之间存在非线性关系。MLPR 呈 J 型曲线,而 MLR 与 AKI 的关系呈良好的 S 型曲线。特别是,MLPR 是一种很有前景的用于早期 CSA-AKI 预测的临床综合指标。这些发现强调了 MLPR 作为临床实践中及时发现和处理 CSA-AKI 的重要工具的意义。
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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
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