Hubungan Platelet Lymphocyte Ratio (PLR) dengan Status Mortalitas H-28 pada Pasien Sepsis Associated Acute Kidney Injury

Franz Josef Tarigan, Tinni T. Maskoen, Dhany Budipratama

Abstract


Inflamasi merupakan proses yang berperan penting dalam perkembangan Sepsis-associated acute kidney injury (S-AKI). Rasio platelet-limfosit (PLR) merupakan penanda inflamasi baru yang mulai sering digunakan untuk memperkirakan mortalitas. Pada fase inflamasi terjadi peningkatan produksi platelet akibat cedera endotel disertai dengan peningkatan rekrutmen limfosit ke ginjal sehingga dapat tergambar pada nilai PLR. Penelitian ini dilakukan untuk melihat hubungan PLR dengan mortalitas pada pasien S-AKI di ICU RSUP Dr. Hasan Sadikin. Metode yang digunakan pada penelitian ini adalah case-control secara retrospektif dengan menggunakan rekam medis 136 pasien S-AKI di ICU RSUP Dr. Hasan Sadikin pada tahun 2021–2022 yang sesuai dengan kriteria inklusi dan eksklusi dan dibagi menjadi kelompok bertahan hidup 68 orang dan kelompok mortal 68 orang. Penelitian dilakukan mulai dari Maret 2022 sampai Februari 2023. Pengambilan sampel dilakukan secara vkonsekutif, kemudian dilakukan analisis statistik chi-square untuk melihat hubungan nilai PLR dengan status mortalitas h-28. Didapatkan rasio odd pada PLR sebesar 165 dan nilai cut-off PLR penelitian ini adalah 120. Terdapat hubungan antara nilai PLR dan mortalitas h-28 pada pasien S-AKI. Pasien dengan nilai PLR≥120 memiliki risiko mortalitas h-28 lebih tinggi. Peningkatan nilai rasio platelet dan limfosit pada pasien cedera ginjal akut akibat sepsis yang mortal terjadi karena peningkatan penggunaan leukosit ke ginjal dan peningkatan produksi platelet akibat inflamasi yang berat.


Keywords


Rasio platelet limfosit; sepsis; sepsis-associated acute kidney injury; status mortalitas

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References


  1. Vijayaraghavan BKT, Adhikari NKJ. Sepsis epidemiology and outcomes in asia advancing the needle. Am J Respir Crit Care Med. 2022;206(9):1059 ̶ 60.
  2. Chiu C, Legrand M. Epidemiology of sepsis and septic shock. Curr Opin Anaesthesiol. 2021;34(2):71–6.
  3. Bellomo R, Kellum JA, Ronco C, Wald R, Martensson J, Bagshaw SM, dkk. Acute kidney injury in sepsis. Intensive Care Med. 2017;43(6):816–28.
  4. Driessen RGH, Heijnen NFL, Hulsewe RPMG, Holtkamp JWN, Winkes B, Van de Poll MCG, dkk. Early ICU-mortality in sepsis–causes, influencing factors and variability in clinical judgement: a retrospective cohort study. Infect Dis (Auckl). 2021;53(1):61–8.
  5. Al Ghozy AR, El Hallage M, Khalid M, Abdalla K. The quick sequential organ failure assessment score for predicting outcome in patients with sepsis and evidence of multiorgan failure at the time of emergency department presentation. Crit Care Shock. 2022;25(3):143–56.
  6. Hu H, Li L, Zhang Y, Sha Tong, Huang Q, Guo X, dkk. A Prediction Model for Assessing Prognosis in Critically Ill Patients with Sepsis-associated acute kidney injury. Shock. 2021;56(4):564–72.
  7. Guclu E, Durmaz Y, Karabay O. Effect of severe sepsis on platelet count and their indices. Afr Health Sci. 2013;13(2):333–8.
  8. Wang HE, Muntner P, Chertow GM, Warnock DG. Acute kidney injury and mortality in hospitalized patients. Am J Nephrol. 2012;35(4):349–55.
  9. Chang YM, Chou YT, Kan WC, Shiao CC. Sepsis and acute kidney injury: a review focusing on the bidirectional interplay. Int J Mol Sci. 2022;23(16):9159.
  10. Pinheiro KHE, Azêdo FA, Areco KCN, Laranja SMR. Risk factors and mortality in patients with sepsis, septic and non septic acute kidney injury in ICU. J Bras Nefrol. 2019;41(4):462–71.
  11. Peerapornratana S, Manrique-Caballero CL, Gómez H, Kellum JA. Acute kidney injury from sepsis: current concepts, epidemiology, pathophysiology, prevention and treatment. Kidney Int. 2019;96(5):1083–99.
  12. Rabb H, Griffin MD, McKay DiB, Swaminathan S, Pickkers P, Rosner MH, dkk. Inflammation in AKI: current understanding, key questions, and knowledge gaps. J Am Soc Nephrol. 2016;27(2):371–9.
  13. Cao C, Yao Y, Zeng R. Lymphocytes: versatile participants in acute kidney injury and progression to chronic kidney disease. Front Physiol. 2021;12:1–18.
  14. Bagshaw SM, Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M, dkk. Septic acute kidney injury in critically ill patients: clinical characteristics and outcomes. Clin J Am Soc Nephrol. 2007;2(3):431–9.
  15. Aggrey AA, Srivastava K, Ture S, Field DJ, Morrell CN. Platelet induction of the acute-phase response is protective in murine experimental cerebral malaria. J Immunol. 2013;190(9):4685–91.
  16. Morrell CN, Aggrey AA, Chapman LM, Modjeski KL. Emerging roles for platelets as immune and inflammatory cells. Blood. 2014;123(18):2759–67.
  17. Chen Y, Feng F, Li M, Yuan JJ, Ni Chang X, Hua Wei B, dkk. Relationship between platelet/lymphocyte ratio and prognosis of patients with septic acute kidney injury: a pilot study. J Chinese Med Assoc. 2020;83(11):1004–7.
  18. Shen Y, Huang X, Zhang W. Platelet-to-lymphocyte ratio as a prognostic predictor of mortality for sepsis: interaction effect with disease severity-a retrospective study. BMJ Open. 2019;9(1):1–7.
  19. Mezzaroba AL, Larangeira AS, Morakami FK, Junior JJ, Vieira AA, Costa MM, dkk. Evaluation of time to death after admission to an intensive care unit and factors associated with mortality: A retrospective longitudinal study. Int J Crit Illn Inj Sci. 2022;12(3):121–6.
  20. Zheng CF, Liu WY, Zeng FF, Hua Zeng M, Ying Shi H, Zhou Y, dkk. Prognostic value of platelet-to-lymphocyte ratios among critically ill patients with acute kidney injury. Crit Care. 2017;21(1):1–11.
  21. Sairam S, Domalapalli S, Muthu S, Swaminathan J, Ramesh VA, Sekhat L, dkk. Hematological and biochemical parameters in apparently healthy indian population: defining reference intervals. Indian J Clin Biochem. 2014;29(3):290–7.




DOI: https://doi.org/10.15851/jap.v12n1.3626

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