The relationship between lactate/albumin ratio and prognosis in children with acute kidney injury

Abstract

Acute kidney injury (AKI) is a prevalent and critical complication in pediatric patients, severely influencing both survival outcomes and quality of life. This research seeks to evaluate the prognostic value of the lactate/albumin ratio (LAR) in predicting short-term outcomes for children diagnosed with AKI. A retrospective analysis was conducted using data from the Pediatric Intensive Care database, covering the period from 2010 to 2018. The relationship between the LAR and in-hospital mortality was explored using smoothing curve fitting, multivariate logistic regression, and Kaplan-Meier survival analysis. Receiver operating characteristic (ROC) analysis was performed to evaluate the predictive capability of LAR for in-hospital mortality. A total of 631 pediatric patients with AKI were included in this study. Smoothing curve fitting revealed a nearly linear positive association between the LAR and in-hospital mortality. Multivariate logistic regression analysis identified LAR as an independent predictor of in-hospital mortality (OR 2.58, 95% CI 1.85–3.59). Kaplan-Meier survival analysis showed that patients with a higher LAR had a significantly greater 30-day mortality rate compared to those with lower LAR values. ROC curve analysis demonstrated an area under the curve of 0.85 (95% CI 0.80–0.90). At the optimal cutoff value of 0.80, the sensitivity was 80.42%, specificity was 77.97%, and accuracy was 80.19%. These results suggest that LAR is a promising prognostic indicator of mortality in pediatric patients with AKI, and could serve as an early indicator of risk stratification.