The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke

ObjectivesAcute kidney injury (AKI) is a serious complication of acute hemorrhagic stroke (AHS). Early detection and early treatment are crucial for patients with AKI. We conducted a study to analyze the role of the monocyte-to-lymphocyte ratio (MLR) in predicting the development of AKI after AHS.Me...

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Main Authors: Fen Jiang, Jialing Liu, Xin Yu, Rui Li, Run Zhou, Jianke Ren, Xiangyang Liu, Saili Zhao, Bo Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-06-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2022.904249/full
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author Fen Jiang
Jialing Liu
Xin Yu
Rui Li
Run Zhou
Jianke Ren
Xiangyang Liu
Saili Zhao
Bo Yang
author_facet Fen Jiang
Jialing Liu
Xin Yu
Rui Li
Run Zhou
Jianke Ren
Xiangyang Liu
Saili Zhao
Bo Yang
author_sort Fen Jiang
collection DOAJ
description ObjectivesAcute kidney injury (AKI) is a serious complication of acute hemorrhagic stroke (AHS). Early detection and early treatment are crucial for patients with AKI. We conducted a study to analyze the role of the monocyte-to-lymphocyte ratio (MLR) in predicting the development of AKI after AHS.MethodsThis retrospective observational study enrolled all subjects with AHS who attended the neurosurgical intensive care unit (NSICU) at the First Affiliated University of South China between 2018 and 2021. Patient demographics, laboratory data, treatment details, and clinical outcomes were recorded.ResultsOf the 771 enrolled patients, 180 (23.3%) patients developed AKI. Compared to patients without AKI, those with AKI had a higher MLR and the neutrophil-lymphocyte ratio (NLR) at admission (P < 0.001). The MLR and the NLR at admission were associated with an increased AKI risk, with odds ratios (ORs) of 8.27 (95% CI: 4.23, 16.17, p < 0.001) and 1.17 (95% CI: 1.12, 1.22, p < 0.001), respectively. The receiver operating characteristic curve (ROC) analysis was conducted to analyze the ability of the MLR and NLR to predict AKI, and the areas under the curve (AUCs) of the MLR and the NLR were 0.73 (95% CI: 0.69, 0.77, p < 0.001) and 0.67 (95% CI: 0.62, 0.72, p < 0.001), with optimal cutoff values of 0.5556 and 11.65, respectively. The MLR and the NLR at admission were associated with an increased in-hospital mortality risk, with ORs of 3.13 (95% CI: 1.08, 9.04) and 1.07 (95% CI: 1.00, 1.14), respectively. The AUCs of the MLR and the NLR for predicting in-hospital mortality were 0.62 (95% CI: 0.54, 0.71, p = 0.004) and 0.52 (95% CI: 0.43, 0.62, p = 0.568), respectively. The optimal cutoff value for the MLR was 0.7059, with a sensitivity of 51% and a specificity of 73.3%.ConclusionsMLR and NLR measurements in patients with AHS at admission could be valuable tools for identifying patients at high risk of early AKI. The MLR was positively associated with in-hospital mortality and the NLR showed a weak ability for the prediction of in-hospital mortality.
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spelling doaj.art-94e9e1558e124bfcbecc6734033c781b2022-12-22T02:39:07ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-06-011310.3389/fneur.2022.904249904249The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic StrokeFen Jiang0Jialing Liu1Xin Yu2Rui Li3Run Zhou4Jianke Ren5Xiangyang Liu6Saili Zhao7Bo Yang8Department of Nephrology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, ChinaDepartment of Nephrology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, ChinaDepartment of Nephrology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, ChinaDepartment of Nephrology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, ChinaDepartment of Gastroenterology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, ChinaDepartment of Nephrology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, ChinaDepartment of Clinical Medicine, Xiangnan University, Chenzhou, ChinaDepartment of Nursing, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, ChinaDepartment of Nephrology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, ChinaObjectivesAcute kidney injury (AKI) is a serious complication of acute hemorrhagic stroke (AHS). Early detection and early treatment are crucial for patients with AKI. We conducted a study to analyze the role of the monocyte-to-lymphocyte ratio (MLR) in predicting the development of AKI after AHS.MethodsThis retrospective observational study enrolled all subjects with AHS who attended the neurosurgical intensive care unit (NSICU) at the First Affiliated University of South China between 2018 and 2021. Patient demographics, laboratory data, treatment details, and clinical outcomes were recorded.ResultsOf the 771 enrolled patients, 180 (23.3%) patients developed AKI. Compared to patients without AKI, those with AKI had a higher MLR and the neutrophil-lymphocyte ratio (NLR) at admission (P < 0.001). The MLR and the NLR at admission were associated with an increased AKI risk, with odds ratios (ORs) of 8.27 (95% CI: 4.23, 16.17, p < 0.001) and 1.17 (95% CI: 1.12, 1.22, p < 0.001), respectively. The receiver operating characteristic curve (ROC) analysis was conducted to analyze the ability of the MLR and NLR to predict AKI, and the areas under the curve (AUCs) of the MLR and the NLR were 0.73 (95% CI: 0.69, 0.77, p < 0.001) and 0.67 (95% CI: 0.62, 0.72, p < 0.001), with optimal cutoff values of 0.5556 and 11.65, respectively. The MLR and the NLR at admission were associated with an increased in-hospital mortality risk, with ORs of 3.13 (95% CI: 1.08, 9.04) and 1.07 (95% CI: 1.00, 1.14), respectively. The AUCs of the MLR and the NLR for predicting in-hospital mortality were 0.62 (95% CI: 0.54, 0.71, p = 0.004) and 0.52 (95% CI: 0.43, 0.62, p = 0.568), respectively. The optimal cutoff value for the MLR was 0.7059, with a sensitivity of 51% and a specificity of 73.3%.ConclusionsMLR and NLR measurements in patients with AHS at admission could be valuable tools for identifying patients at high risk of early AKI. The MLR was positively associated with in-hospital mortality and the NLR showed a weak ability for the prediction of in-hospital mortality.https://www.frontiersin.org/articles/10.3389/fneur.2022.904249/fullmonocyte-to-lymphocyte ratioacute kidney injuryacute hemorrhagic strokepredictionin-hospital mortality
spellingShingle Fen Jiang
Jialing Liu
Xin Yu
Rui Li
Run Zhou
Jianke Ren
Xiangyang Liu
Saili Zhao
Bo Yang
The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke
Frontiers in Neurology
monocyte-to-lymphocyte ratio
acute kidney injury
acute hemorrhagic stroke
prediction
in-hospital mortality
title The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke
title_full The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke
title_fullStr The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke
title_full_unstemmed The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke
title_short The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke
title_sort monocyte to lymphocyte ratio predicts acute kidney injury after acute hemorrhagic stroke
topic monocyte-to-lymphocyte ratio
acute kidney injury
acute hemorrhagic stroke
prediction
in-hospital mortality
url https://www.frontiersin.org/articles/10.3389/fneur.2022.904249/full
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