Can the Fibrinogen-Albumin Ratio be a Predictor of Mortality in Dialysis Patients?

Abstract

Objectives: Renal failure is linked to both acute and chronic inflammatory processes for a number of reasons, particularly in end-stage renal disease. Although it has demonstrated potential as an inflammatory marker in a number of diseases, the fibrinogen-to-albumin ratio’s (FAR) predictive significance in critically ill dialysis patients is yet unknown. The purpose of this study was to look into FAR as a possible mortality predictive indicator in this particular patient population. Materials and Methods: A retrospective analysis of 226 patients admitted to the intensive care units of internal medicine and anesthesia, undergoing dialysis between 12.12.2021 and 15.12.2023, was conducted. Inclusion criteria were age ≥18, diagnosis of albumin or kidney disease, and availability of complete clinical and laboratory data. Exclusion criteria included anemia unrelated to kidney disease and inability to access relevant data. Demographic, clinical, and laboratory variables were collected, and statistical analyses were performed. Results: The study revealed significant associations between mortality and lower body mass index, higher APACHE II score, elevated creatinine levels, lower glomerular filtration rate, higher albumin levels, and increased FAR. With an 81.75% sensitivity, 39.00% specificity, 62.80% positive predictive value, and 62.90% negative predictive value, the FAR cut-off point for mortality was found to be 241. Area under the curve of 58.1% was shown by receiver operating characteristic analysis. Conclusion: FAR shows promise as a prognostic indicator for mortality in intensive care dialysis patients. While further prospective and multicenter studies are needed to validate its clinical usability, FAR could contribute to enhanced prognostic assessments and improved patient care in this specific population. Key Words: Fibrinogen albumin ratio, mortality, acute kidney injury, chronic kidney disease

Keywords

• Fibrinogen albumin ratio
• mortality
• acute kidney injury
• chronic kidney disease

Fibrinojen-Albümin Oranı Diyaliz Hastalarında Mortalitenin Bir Belirleyicisi Olabilir mi?

Abstract

Amaç: Böbrek yetmezliği, özellikle son dönem böbrek hastalığında, çeşitli faktörlere bağlı akut ve kronik enflamatuvar süreçlerle ilişkilidir. Fibrinojen albümin oranı (FAR) çeşitli hastalıklarda enflamatuvar bir belirteç olarak umut vaat etmektedir, ancak yoğun bakım diyaliz hastalarında prognostik değeri belirsizliğini korumaktadır. Bu çalışmanın amacı, bu spesifik hasta popülasyonunda mortalite için potansiyel bir prognostik indeks olarak FAR’yi araştırmaktır. Gereç ve Yöntem: Dahiliye ve anestezi yoğun bakım ünitelerine 12.12.2021 ile 15.12.2023 tarihleri arasında diyalize giren 226 hastanın retrospektif analizi yapıldı. Dahil edilme kriterleri yaş ≥18, albümin veya böbrek hastalığı tanısı ve tam klinik ve laboratuvar verilerinin mevcut olmasıydı. Dışlama kriterleri arasında böbrek hastalığı ile ilişkili olmayan anemi ve ilgili verilere erişememe yer aldı. Demografik, klinik ve laboratuvar değişkenleri toplandı ve istatistiksel analizler yapıldı. Bulgular: Çalışmada mortalite ile düşük vücut kitle indeksi, yüksek APACHE II skorları, yüksek kreatinin seviyeleri, düşük glomerüler filtrasyon hızı, yüksek albümin seviyeleri ve artmış FAR arasında anlamlı ilişkiler tespit edilmiştir. Mortalite için FAR kesme noktası %81,75 duyarlılık, %39 özgüllük%62,80 pozitif prediktif değer ve %62,90 negatif prediktif değer ile 241 olarak belirlenmiştir. ROC analizine göre eğri altındaki alan %58,1 bulundu. Sonuç: FAR, yoğun bakım diyaliz hastalarında mortalite için prognostik bir gösterge olarak umut vaat etmektedir. Klinik kullanılabilirliğini doğrulamak için daha ileri prospektif ve çok merkezli çalışmalara ihtiyaç duyulsa da, FAR bu spesifik popülasyonda gelişmiş prognostik değerlendirmelere ve iyileştirilmiş hasta bakımına katkıda bulunabilir. Anahtar Kelimeler: Fibrinojen albümin oranı, mortalite, akut böbrek hasarı, kronik böbrek hastalığı

Keywords

• Fibrinojen albümin oranı
• mortalite
• akut böbrek hasarı
• kronik böbrek hastalığı

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