Evaluation of the relationship between RDW/albumin ratio andmortality in patients with acute kidney injury developing in sepsis

Evaluation of the Relationship Between RDW/Albumin Ratio and Mortality in Patients with Acute Kidney Injury Developing in Sepsis Aim: This study aimed to evaluate the relationship between the RDW/Albumin ratio and mortality in patients diagnosed with acute kidney injury (AKI) due to sepsis who were hospitalized at Süleyman Demirel University Faculty of Medicine Hospital over the past five years. Materials and Methods: The study was initiated after obtaining approval from the Süleyman Demirel University Health Sciences Ethics Committee Subcommittee (approval date: 03.10.2024 approval number: E.852488). This is a retrospective, descriptive, cross-sectional study. Results: A total of 225 patients were included in the study. Of these, 46% (n=103) were female, and 54% (n=122) were male, with a mean age of 68.49 ± 15.19 years. The mortality rate was 53.8% (n=121). Significant differences were observed between the deceased and surviving groups in terms of WBC (p = 0.027), neutrophil count (p = 0.020), hemoglobin (p = 0.003), platelet count (p = 0.006), pH (p = 0.001), pCO₂ (p = 0.001), HCO₃ (p = 0.004), lactate (p = 0.001), AST (p = 0.001), ALT (p = 0.002), total bilirubin (p = 0.001), albumin (p = 0.001), PT (p = 0.001), INR (p = 0.001), RDW/ALB (p = 0.001), CRP/ALB (p = 0.001), sodium (p = 0.001), creatinine (p = 0.014), BUN (p = 0.001), urea (p = 0.001), SOFA (p = 0.001), and SAPS (p = 0.001). Logistic regression analysis identified RDW/ALB ratio (OR = 1.565, p = 0.001), CRP/ALB ratio (OR = 1.011, p = 0.001), SOFA (OR = 1.722, p = 0.001), and SAPS (OR = 1.083, p = 0.001) as significant risk factors for mortality. ROC analysis determined significant cut-off values for CRP/ALB ratio (cut-off = 70.28, p = 0.001) and RDW/ALB ratio (cut-off = 6.11, p = 0.001). Conclusions: The RDW/ALB and CRP/ALB ratios were found to be important prognostic markers in predicting mortality in patients with sepsis and acute kidney injury. These results suggest that these biomarkers could be integrated into clinical practice for early risk stratification and prognosis estimation in sepsis patients. Keywords: Sepsis, AKI, RDW/ALB.