外周血AFR、sUAR与急性呼吸窘迫综合征患者并发急性肾损伤的关系研究OA

Objective To investigate the relationship of the peripheral blood albuminto-fibrinogen ratio(AFR)and the serum uric acidto-albumin ratio(sUAR)with acute kidney injury(AKI)in patients with acute respiratory distress syndrome(ARDS),as well as their predictive value.Methods A total of 109 ARDS patients admitted to Fuyang People's Hospital from January 2023 to December 2024 were selected.Patients were divided into AKI-complicated group(n=20)and nonAKI-complicated group(n=89)according to occurrence of AKI during hospitalization.The general characteristics,peripheral blood AFR and sUAR values of the two groups were compared.The influencing factors for AKI complicating ARDS and the predictive value of peripheral blood AFR and sUAR for AKI complication were analyzed.The relationship between the two indicators and AKI risk in ARDS patients and their interaction for AKI complication were also analyzed.Results The peripheral blood sUAR in the AKI-complicated group was higher,whereas AFR was lower than those in the nonAKI-complicated group(P＜0.05).Multivariate logistic regression analysis showed that peripheral blood AFR and sUAR were independent influencing factors for AKI complicating ARDS(P＜0.05).Receiver operating characteristic(ROC)curve analysis revealed that the area under curve(AUC)of combined prediction of AFR and sUAR for AKI complicating ARDS reached 0.898,with a sensitivity of 90.00％and a specificity of 86.52％.Restricted cubic spline model analysis indicated that there existed a nonlinear doseresponse relationship between peripheral blood AFR,sUAR and the risk of AKI complicating ARDS(P＜0.05).Interaction analysis demonstrated that simultaneous exposure to peripheral blood AFR and sUAR exerted a synergistic effect on the risk of AKI in ARDS patients,and the synergistic effect was 2.165 times the sum of effects induced by individual exposure of each indicator(P＜0.05).Conclusion Peripheral blood AFR and sUAR are associated with complicated AKI complicating ARDS.Their combination can provide reference for predicting AKI risk in ARDS pantients and assist clinical prevention and treatment.