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Objective@#We aimed to investigate uric acid and albumin ratio (UA/A) as a marker of short-term mortality in acute kidney injury (AKI). Both uric acid and albumin are strongly correlated with the development and mortality of AKI. @*Methods@#The patients hospitalized from May 2019 to September 2019 for AKI were included in this study. The diagnostic odds ratio (DOR), Youden index (J), and the area under a receiver operating characteristic curve (AUROC) determined a cut-off UA/A ratio for mortality. Cox-regression analysis was performed to identify UA/A as a prognostic marker of the 30-day mortality rate. @*Results@#A total of 171 patients with an average age of 69.20±13.0 (45.6% women) were included in the study. The average UA/A ratio was 3.3±1.5 mg/g and 2.5±1.0 mg/g in the non-survivor and survivor groups, respectively (P=0.001). The best cut-off UA/A ratio associated with mortality was determined as 2.4 mg/g with a specificity of 52% and a sensitivity of 77% (DOR, 3.6; J, 28.8; AUROC, 0.644). Thirty-day cumulative survival rates of the low and high UA/A ratio groups were 85.9±4.0% and 63.7±5.0%, respectively. The estimated survival times of the low and high UA/A ratio groups were 27.7 days (95% confidence interval [CI], 26.2–29.3) and 23.9 days (95% Cl, 22.0–25.9), respectively. @*Conclusion@#We found a direct correlation between 30-day mortality and UA/A ratio at initial presentation in AKI patients regardless of age, comorbidities, and clinical and laboratory findings, including albuminuria.
RESUMEN
Objective@#We aimed to investigate uric acid and albumin ratio (UA/A) as a marker of short-term mortality in acute kidney injury (AKI). Both uric acid and albumin are strongly correlated with the development and mortality of AKI. @*Methods@#The patients hospitalized from May 2019 to September 2019 for AKI were included in this study. The diagnostic odds ratio (DOR), Youden index (J), and the area under a receiver operating characteristic curve (AUROC) determined a cut-off UA/A ratio for mortality. Cox-regression analysis was performed to identify UA/A as a prognostic marker of the 30-day mortality rate. @*Results@#A total of 171 patients with an average age of 69.20±13.0 (45.6% women) were included in the study. The average UA/A ratio was 3.3±1.5 mg/g and 2.5±1.0 mg/g in the non-survivor and survivor groups, respectively (P=0.001). The best cut-off UA/A ratio associated with mortality was determined as 2.4 mg/g with a specificity of 52% and a sensitivity of 77% (DOR, 3.6; J, 28.8; AUROC, 0.644). Thirty-day cumulative survival rates of the low and high UA/A ratio groups were 85.9±4.0% and 63.7±5.0%, respectively. The estimated survival times of the low and high UA/A ratio groups were 27.7 days (95% confidence interval [CI], 26.2–29.3) and 23.9 days (95% Cl, 22.0–25.9), respectively. @*Conclusion@#We found a direct correlation between 30-day mortality and UA/A ratio at initial presentation in AKI patients regardless of age, comorbidities, and clinical and laboratory findings, including albuminuria.
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Objectives: To investigate the factors which might influence the sonographic fetal weight estimation [SFWE] accuracy
Methods: This prospective study was conducted among 949 singleton term pregnant women who delivered at a tertiary center, from January 2017 to December 2017. All participants' maternal [i.e. parity, age, body mass index and gestational weight gain during pregnancy], fetal sonographic [i.e. fetal presentation, amniotic fluid index, localization of placenta and estimated fetal weight] and neonatal [birth weight and gender] characteristics were recorded. A p<0.05 was considered significant
Results: The mean absolute percent error [APE] values of SFWE was 8.2+/-6.5 percent, and overall failure ratio [APE >10%] was 33%. In failure group, primiparous woman and cephalic presentation fetus were significantly more common compared to accuracy group [55.9% vs.44.8%; p=0.001 and 98% vs. 95.2%; p=0.03, respectively]. In contrast, the mean neonatal birth weight [NBW] value was significantly lower in failure group compared to success group [3250+/-565 gr vs. 3404+/-410 gr; p=0.001]. The correlation between SFWE and NBW was linear, however negative, and significant [p=0.001]. Logistic regression analysis revealed that primiparous woman, cephalic presentation fetus and <3300 gr NBW were independent risk factors for the SFWE failure [relative risks were 1.6, 2.8 and 2.4 respectively, p<0.05]
Conclusion: SFWE has a high correlation with NBW, however it's accuracy is still unsatisfactory, and depend on many unpredictable and inconsistent factors