The Value Of Platelet To Lymphocyte Ratio In Children With Sepsis-related Acute Kidney Injury

Objective: To study the value of platelet to lymphocytes ratio(PLR)in children with sepsis-related acute kidney injury.Methods: A retrospective analysis was performed on 94 children diagnosed with sepsis in the Pediatric Intensive Care Unit(PICU)of the Children’s Hospital of Chongqing Medical University from January,2017 to December,2019.According to changes in blood creatinine(SCr)and urine volume,41 cases were classified into sepsis-AKI group and 53 cases were sepsis non-AKI group.Collect the general situation of children,related clinical data and laboratory indicators.Using SPSS 23.0 software,univariate and binary logistic regression analysis,the risk factors of AKI in children with sepsis were determined,and the best cut-off point of PLR was determined by ROC curve.The PLR in 100 children with health checkup from January 2019 to December 2019 was selected as the normal group in this study.Results: There were no significant differences in age and genderbetween 100 children in the normal group and 94 children in the sepsis group.The PLR of children in the sepsis group was 119.7(106.83,144.41),and the PLR of the normal group was 92.48(70.16,124.51).The difference was statistically significant(P<0.05).In the sepsis group,univariate analysis showed that age,weight,septic shock,critical illness score,PLR,and lactic acid were risk factors for AKI in children with sepsis(P<0.05).It was included in the logistic regression analysis,and PLR was an independent risk factor for AKI in children with sepsis(P<0.05).The area under the ROC curve of PLR for the diagnosis of sepsis-related AKI was 0.822(95%CI 0.732-0.912),which was higher than serum creatinine and urea nitrogen.At the same time,the area under the ROC curve of AKI is also higher than the white blood cell count and procalcitonin.According to the Jordon index method,the PLR was cut off at 130.59,and its sensitivity and specificity for the diagnosis of sepsis-related AKI were 72.6% and 83%,respectively.Conclusion:The platelet to lymphocyte ratio is an independent risk factor for AKI in children with sepsis.PLR can be used as an inflammatory marker in the early diagnosis of sepsis-associated acute kidney injury in children,and to a certain extent,it is superior to traditional renal function markers.