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논문분류	춘계학술대회 초록집
제목	The Predictive Value of a Composite Inflammatory-Metabolic Index for In-Hospital Mortality in Patients Undergoing CKRT
저자	Ji Hyun Jeon
출판정보	2026; 2026(1):
키워드	Inflammatory-Metabolic Index, In-Hospital Mortality, CKRT
초록	Objectives: This study aimed to evaluate the prognostic value of the Lactate–CRP/Albumin Ratio (L-CAR)—a composite inflammatory-metabolic index—at the time of continuous kidney replacement therapy (CKRT) initiation for predicting in-hospital mortality in critically ill patients with acute kidney injury (AKI). Methods: We conducted a retrospective observational study of 177 patients who initiated CKRT between January 2020 and September 2021 at a tertiary care university hospital. Patients with pre-existing end-stage kidney disease receiving maintenance hemodialysis were excluded. Clinical characteristics and laboratory parameters, including lactate, C-reactive protein (CRP), and albumin, were collected at the onset of CKRT. The L-CAR was calculated using the following formula: [Lactate (mmol/L) X CRP (mg/dL)] / Albumin (g/dL)] and expressed as a dimensionless index. Results: Of the 177 patients, 83 (46.9%) died during hospitalization. The non-survivor group exhibited significantly higher lactate levels and lower nutritional markers (total protein and albumin) compared to the survivor group (P < 0.05). Notably, the non-survivor group also had significantly lower baseline creatinine levels, suggesting a potential loss of muscle mass or reduced production. The L-CAR was markedly higher in patients who died (P < 0.001). Multivariable Cox proportional hazards analysis revealed that L-CAR was independently associated with in-hospital mortality (Adjusted Hazard Ratio [aHR 1.013 ; P < 0.05) after adjusting for age, sex, PaO2, serum creatinine, sodium, and potassium level. [Figure 1] Conclusion: The L-CAR measured at CKRT initiation is a potent and independent predictor of in-hospital mortality in critically ill patients. By integrating metabolic stress (lactate), systemic inflammation (CRP), and nutritional reserve (albumin), this simple composite biomarker provides a robust tool for early risk stratification and clinical decision-making in the management of patients undergoing CKRT.
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