Correlation Between Mean Platelet Volume,Red Blood Cell Distribution Width And Acute Kidney Injury In Patients With Sepsis

Objectives To investigate the clinical correlation between mean platelet volume(MPV),red blood cell distribution width(RDW)and acute kidney injury(AKI)in patients with sepsis.Methods Retrospective analysis was conducted on patients admitted to the Intensive care unit(ICU)of The Affiliated Hospital of North China University of Science and Technology from January 2019 to September 2021 who met sepsis3.0 diagnostic criteria.According to inclusion and exclusion criteria,133 sepsis patients who met the research conditions were finally selected.1)All patients were divided into AKI group(77 cases)and non-AKI group(56 cases)according to whether AKI occurred within 28 days after enrollment to evaluate the correlation between MPV,RDW and AKI in sepsis patients within 28-day;2)The patients in AKI group were further divided into death group(35cases)and survival group(42 cases)based on 28-day survival situation,to evaluate the correlation between MPV,RDW and the prognosis of patients with sepsis associated acute kidney injury(SA-AKI);3)All sepsis patients who died within 28 days after enrollment were divided into AKI death group(35 cases)and non-AKI death group(21cases)according to whether AKI had occurred before death.The association between MPV,RDW and death in sepsis patients was evaluated.General information including gender,age,basic coexisting diseases(hypertension,diabetes,coronary heart disease)were recorded in each group.Calculated acute physiology and chronic health assessment(APACHE)Ⅱ score and sequential organ failure assessment(SOFA)score on the first24 hours after admission to ICU.MPV(admission MPV),RDW(admission RDW),lactic acid(Lac),procalcitonin(PCT)and other laboratory report at admission in ICU were recorded.Recorded MPV and RDW at diagnosis of AKI and MPV(end point MPV)and RDW(end point RDW)at death/discharge of patients on day 28 or less than 28 days after admission.Results 1 There was no significant difference between AKI group and non-AKI group in gender,age,basic coexisting diseases,utilization rate of mechanical ventilation and vasoactive drugs,Lac(P>0.05).The utilization rate of continuous renal replacement therapy(CRRT),APACHEⅡ score,PCT,admission MPV and admission RDW in sepsis AKI group were higher than those in non-AKI group,with statistically significant differences(P<0.05).2 Multivariate logistic regression analysis showed that higher level of admission MPV and admission RDW were independent risk factors for AKI in sepsis patients.3 The analysis of receiver operating characteristic(ROC)curve showed that higher levels of admission MPV and admission RDW had predictive value for AKI in patients with sepsis.Their area under the curve(AUC)were 0.681 and 0.697,the same sensitivity was 0.649,and the specificity were 0.643 and 0.732.The accuracy of their separate prediction was low,but the accuracy can be improved by combined detection.4There was no significant difference in gender,age,basic complication and utilization rate of mechanical ventilation between SA-AKI death group and survival group(P>0.05);The utilization rate of vasoactive drug and CRRT,APACHEII score,PCT,Lac,admission MPV,admission RDW,MPV at diagnosis,RDW at diagnosis,end point MPV,end point RDW in SA-AKI death group were significantly higher than those in survival group(P<0.05).5 Multivariate logistic regression analysis showed that the independent risk factors affecting the prognosis of patients with SA-AKI were APACHEII score and higher admission MPV,admission RDW,end point MPV,end point RDW(P<0.05).6APACHEII score,admission RDW,end point MPV and end point RDW were independent predictors of prognosis in patients with SA-AKI.According to the area under the ROC curve,the accurate order of prediction was end point MPV>end point RDW>APACHEII score>admission RDW.7 There was no significant difference in the levels of admission MPV and admission RDW between sepsis non AKI death group and AKI death group(P>0.05).Conclusions Higher level of MPV and RDW are correlated with AKI in patients with sepsis,and can predict the clinical outcomes of SA-AKI patients.Figure2;Table9;Reference 130...