Nghiên cứu giá trị của tỷ lệ C-reactive protein/albumin huyết tương trong tiên lượng tổn thương thận cấp ở bệnh nhân viêm tụy cấp

Acute pancreatitis (AP) is a severe inflammatory condition that can lead to multi-organ dysfunction, with acute kidney injury (AKI) being a particularly serious complication, significantly increasing morbidity and mortality. Early and accurate prediction of AKI in AP patients is crucial for timely therapeutic intervention and improving patient outcomes. Traditional markers often provide a fragmented view of the systemic response. The C-reactive protein/Albumin ratio (CAR) is emerging as a potentially comprehensive prognostic indicator, integrating both inflammatory status (CRP) and nutritional/fluid balance (Albumin). This study aims to evaluate the prognostic utility of the CAR in identifying the risk of acute kidney injury in patients with acute pancreatitis.

Clinicians and researchers in gastroenterology, nephrology, critical care, and emergency medicine, especially those managing acute pancreatitis and its complications.

This study investigated the prognostic value of the C-reactive protein/Albumin ratio (CAR) for acute kidney injury (AKI) in patients with acute pancreatitis (AP). AKI is a critical complication of AP, associated with high mortality. The rationale for CAR lies in its ability to reflect both systemic inflammation, indicated by C-reactive protein (CRP), and nutritional status/vascular permeability, reflected by Albumin, offering a more holistic view of the disease severity than individual markers. A cross-sectional descriptive analytical study was conducted on 159 AP patients admitted to Bach Mai Hospital between October 2021 and December 2022. Plasma CRP and Albumin levels were measured upon admission to determine their utility in predicting AKI during treatment. The findings revealed that AP patients who developed AKI exhibited significantly higher SOFA scores, lower mean admission blood pressure, lower Albumin levels (28.4 ± 5 g/L vs. 34.9 ± 5.7 g/L), and higher CRP levels (122.8 ± 20.6 mg/L vs. 27.3 ± 12.4 mg/L) compared to those without AKI. The CAR demonstrated significant prognostic value for AKI, with an Area Under the Curve (AUC) of 0.735 (p < 0.001) and an optimal cutoff of 1.0205, yielding a sensitivity of 60.9% and specificity of 84.5%. These results underscore CAR as a simple, easily applicable, and valuable index for early prediction of AKI in AP patients, facilitating proactive clinical management and potentially improving patient outcomes.