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Asociación de la relación neutrófilos, linfocitos y plaquetas con lesión renal aguda en sepsis / Association of neutrophil, lymphocyte, platelet ratio with acute kidney injury in sepsis
Resumen
Resumen
Introducción: la lesión renal aguda (LRA) es frecuente en la sepsis (25 a 51%), tiene alta mortalidad (40 a 80%) y complicaciones a largo plazo. A pesar de su importancia, no contamos con marcadores accesibles en la terapia intensiva. En otras entidades (posquirúrgicos y COVID-19) la relación neutrófilos/linfocitos y plaquetas (N/LP) se ha asociado con lesión renal aguda; sin embargo, no se ha estudiado esta relación en una patología con una respuesta inflamatoria severa como la sepsis.
Objetivo: demostrar la asociación entre la relación N/LP con la LRA secundaria a sepsis en la terapia intensiva.
Material y métodos: estudio de cohorte ambispectiva en pacientes mayores de 18 años que ingresaron con diagnóstico de sepsis a la terapia intensiva. Se calculó la relación N/LP desde el ingreso hasta el séptimo día y hasta el diagnóstico de LRA y el desenlace. El análisis estadístico se realizó con chi cuadrada, V de Cramer y regresión logística multivariable.
Resultados: de los 239 pacientes estudiados, la incidencia de LRA se desarrolló en el 70%. El 80.9% de los pacientes con relación N/LP > 3 tuvieron LRA (p = < 0.0001, V de Cramer 0.458, RM 3.05, IC al 95% 1.602-5.8) y mayor tratamiento sustitutivo renal (21.1 frente a 11.1%, p = 0.043).
Conclusión: la relación N/LP > 3 tiene una asociación moderada con la LRA secundaria a sepsis en la unidad de terapia intensiva.
Abstract
Background: Acute kidney injury (AKI) is frequent in sepsis (25 to 51%), with high mortality (40 to 80%) and long-term complications. Despite its importance we do not have accessible markers in intensive care. In other entities (post-surgical and COVID-19) the neutrophil/lymphocyte and platelet (N/LP) ratio has been associated with acute kidney injury; however, this relationship has not been studied in a pathology with a severe inflammatory response such as sepsis.
Objective: To demonstrate the association between N/LP with AKI secondary to sepsis in intensive care.
Material and methods: Ambispective cohort study in patients over 18 years who were admitted to intensive care with a diagnosis of sepsis. The N/LP ratio was calculated from admission up to the seventh day and up to the diagnosis of AKI and outcome. Statistical analysis was performed with chi squared test, Cramer’s V and multivariate logistic regression.
Results: Out of the 239 patients studied, the incidence of AKI developed in 70%. 80.9% of patients with N/LP ratio > 3 had AKI (p < 0.0001, Cramer’s V 0.458, OR 3.05, 95% CI 1.602-5.8) and increased renal replacement therapy (21.1 vs. 11.1%, p = 0.043).
Conclusion: N/LP ratio > 3 has a moderate association with AKI secondary to sepsis in the intensive care unit.
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