Background: Delta neutrophil index (DNI), representing an elevated fraction of circulating immature granulocytes\nin acute infection, has been reported as a useful marker for predicting mortality in patients with sepsis. The aim of\nthis study was to evaluate the prognostic value of DNI in predicting mortality in septic acute kidney injury (S-AKI)\npatients treated with continuous renal replacement therapy (CRRT).\nMethod: This is a retrospective analysis of consecutively CRRT treated patients. We enrolled 286 S-AKI patients who\nunderwent CRRT and divided them into three groups based on the tertiles of DNI at CRRT initiation (high, DNI > 12.\n0%; intermediate, 3.6ââ?¬â??12.0%; low, < 3.6%). Patient survival was estimated with the Kaplan-Meier method and Cox\nproportional hazards models to determine the effect of DNI on the mortality of S-AKI patients.\nResults: Patients in the highest tertile of DNI showed higher Acute Physiology and Chronic Health Evaluation II\nscore (highest tertile, 27.9 Ã?± 7.0; lowest tertile, 24.6 Ã?± 8.3; P = 0.003) and Sequential Organ Failure Assessment score\n(highest tertile, 14.1 Ã?± 3.0; lowest tertile, 12.1 Ã?± 4.0; P = 0.001). The 28-day mortality rate was significantly higher in\nthe highest tertile group than in the lower two tertile groups (P < 0.001). In the multiple Cox proportional hazard\nmodel, DNI was an independent predictor for mortality after adjusting multiple confounding factors (hazard ratio,\n1.010; 95% confidence interval, 1.001ââ?¬â??1.019; P = 0.036).\nConclusion: This study suggests that DNI is independently associated with mortality of S-AKI patients on CRRT.
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