PROGNOSTIC VALUE OF BLOOD UREA NITROGEN TO ALBUMIN RATIO (BAR) FOR IN-HOSPITAL MORTALITY AMONG PATIENTS WITH ACUTE KIDNEY INJURY (AKI): A MULTICENTER CROSS-SECTIONAL STUDY

7 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-183, Poster Board= FRI-009

Introduction:

Acute kidney Injury (AKI) pertains to an abrupt decline in renal function based on changes in plasma creatinine, urine output, and use of renal replacement therapy, affecting over 13 million people around the world. It was demonstrated that patients with high BUN/albumin ratio (BAR) had increased incidence of AKI and that initial BAR could serve as a good predictor for incident AKI. However, no study published before was made to evaluate the relationship between BAR and incident AKI mortality. Hence, this study was conceptualized to determine if BAR is an independent predictor of in-hospital mortality.

Methods:

This multicenter cross-sectional study was done in two private tertiary referral hospitals in Valenzuela City, Metro Manila and Antipolo City, Rizal. Records of admitted patients from 2010 to 2020 with the diagnosis of AKI and were assessed for eligibility to be included in the study. Patient information was abstracted and encoded in Microsoft Excel (Microsoft Inc., Redmond, Washington, USA). Stata MP version 14 software was used in secondary data analysis. In comparing the prognostic markers across patient outcome, two sample Wilcoxon rank-sum (Mann-Whitney U) test was used. Spearmann Rank correlation analysis was employed in determining the relationship between the clinic-demographic factors and the patient outcome. Logistic regression modeling was done to determine the predictors of in-hospital mortality.

Figure#1: Study Design, Time Frame, Setting and distribution of gender, types of AKI and comorbidities of the population

Results:

Results of this study showed that BAR, blood urea nitrogen, and albumin are not related with mortality. Hypertension, pre-renal and multifactorial disease acute kidney injury, urine output, systolic and diastolic blood pressures, heart and respiratory rate, O2 saturation, eGFR, Charlson comorbidity index, Sequential Organ Failure Assessment, Acute Physiology and Chronic health evaluation, and GCS correlated with mortality in varying magnitude. This study also showed that the complementing CCI score with SBP, DBP, Urine output, or creatinine can be considered to be developed as scoring system for prognostication. 

Table #1: Result of test of Normality and Comparison of Prognostic Parameters and Patient Outcomes 

Conclusions:

Although BAR is not a significant predictor of in-hospital mortality among patients with AKI, Charlson comorbidity index complemented by Systolic Blood pressure, diastolic blood pressure, urine output, and serum creatinine can be potentially considered to be assessed as prognostic parameters for a scoring system.

Table #2: Regression of Patient Outcome with Potential Predictor Variables

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.