Comparative Study between Platelet-To-Lymphocyte Ratio and Serum Creatinine as Prognostic Indicators in Critically Ill Patients with Acute Kidney Injury

Background: Acute kidney injury (AKI) is a syndrome characterized by a rapid (hours to days) deterioration of kid-ney function. It is often diagnosed in the context of other acute illnesses and is particularly common in critically ill patients. The clinical consequences of AKI include the accumulation of waste products, electrolytes, and fluid, but also less obvious ef-fects, including reduced immunity and dysfunction of non-re-nal organs (organ cross-talk). Early diagnosis and management of acute kidney injury is the most effective method for prevent-ing mortality in critically ill patients with acute kidney injury. Aim of Study: To compare the accuracy of platelet-to-lym-phocyte ratio and serum creatinine as predictors of the mor-bidity and mortality in AKI patients admitted to the intensive care unit (ICU). Patients and Methods: This study included 155 patients admitted with the diagnosis of AKI or developed AKI during their ICU stay according to the Kidney Disease Improving Global Outcomes guidelines (KDIGO). No patients were ex-cluded from the study. Patients were classified into two groups according to 28-day mortality; Survivors & Non-survivors. Results: Our study showed a statistically significant differ-ence between platelets to lymphocyte ratio as regards patient outcome, as (79.3%) of the patients with platelets to lympho-cyte ratio (>320) required renal replacement therapy in com-parison to (52%) of patients with PLR (<90) and (51.5%) of patients with PLR (90 – 320). Also, (82.8%) of the patients with platelets to lymphocyte ratio (>320) required vasopres-sor use in comparison to (64%) of patients with PLR (<90) and (49.5%) of patients with PLR (90 – 320). Also, (93.1%) of the patients with platelets to lymphocyte ratio (>320) required mechanical ventilation use in comparison to (64%) of patients with PLR (<90) and (39.6%) of patients with PLR (90 – 320). Also, the median of ICU stay was higher among the patients with platelets to lymphocyte ratio (90 – 320) when compared to the other groups. Conclusion: Both PLR and serum creatinine had sufficient efficacy to predict mortality. PLR had higher ability to predict mortality with higher sensitivity and specificity. It is advised to conduct more studies to investigate the relation between PLR and the need of renal replacement therapy in patients with AKI. PLR could serve as early fair predictor of unfavorable outcomes including need for mechanical ventilation in patients with AKI.