Association between the atherogenic index of plasma and acute kidney injury in sepsis patients

Abstract

Background Although metabolic abnormalities are directly linked to acute kidney injury (AKI) in septic patients, the function of the atherogenic index of plasma (AIP) is yet unknown. Objectives This study examined the relationship between AIP and AKI risk in septic patients, providing insight into the role of lipid metabolism in renal injury. Methods This study investigated patients with sepsis using data from the eICU Collaborative Research Database (eICU-CRD). The AIP was calculated as the base-10 logarithm of the ratio of triglycerides to high-density lipoprotein cholesterol. We employed multivariate logistic regression to evaluate the association between AIP and AKI. Potential nonlinear relationships were assessed using restricted cubic spline (RCS) curve modeling. Additionally, subgroup and sensitivity analyses were conducted to assess the robustness of these findings. Results The median age of the 771 patients was 66.6 years, with 173 (22.4%) developing AKI. A positive linear association was observed between the AIP and the risk of AKI. Specifically, each 0.1-unit increase in AIP was associated with a 10% higher risk of AKI (OR = 1.10, 95% CI: 1.05–1.15, P < 0.001). Sensitivity analyses after excluding patients with renal infections showed that AIP remained associated with the risk of acute kidney injury. Stratified analyses showed no significant interactions (all P for interaction > 0.05) in gender, age, BMI, SOFA score, GCS score, presence of other diseases (diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure). Conclusions For septic patients, the relationship between AIP and risk of AKI was positively linear, with higher AIP indicating higher risk of AKI.