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Background <p>Sepsis-associated acute kidney injury (SA-AKI) is associated with adverse clinical outcomes. The De Ritis ratio (AST/ALT) has been studied as a biomarker for various diseases; however, its relationship with mortality in intensive care unit (ICU) patients with SA-AKI remains unclear.</p> Methods <p>This multicenter retrospective cohort study used data from Medical Information Mart for Intensive Care IV (MIMIC-IV) database and eICU Collaborative Research Database (eICU-CRD). The Boruta algorithm, Kaplan-Meier method, and Cox proportional hazards model was used for the analysis.</p> Results <p>A total of 24,468 patients were included. The De Ritis ratio was significantly higher in deceased patients. The Boruta algorithm identifies it as an important predictor of mortality. Kaplan-Meier analysis showed higher mortality in the groups with elevated De Ritis ratios. Cox analysis indicated that it was a significant risk factor for mortality, with nonlinear associations found using RCS.</p> Conclusion <p>The De Ritis ratio is a significant and independent predictor of mortality in ICU patients with SA-AKI, highlighting its potential clinical utility in assessing prognosis and aiding in treatment decisions. Further prospective studies are required to confirm these findings.</p>

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Association of De Ritis ratio with mortality in ICU patients with sepsis-associated acute kidney injury: a retrospective multicenter cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月19日

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  • Sheng Chen,
  • Xuejin Ye,
  • Lin Guo,
  • Xiaohan Ma,
  • Yiwen Li,
  • Lingling Wu,
  • Ting Zhang,
  • Peng Jiang,
  • Hongjun Gao,
  • Taisheng Liang

摘要

Background

Sepsis-associated acute kidney injury (SA-AKI) is associated with adverse clinical outcomes. The De Ritis ratio (AST/ALT) has been studied as a biomarker for various diseases; however, its relationship with mortality in intensive care unit (ICU) patients with SA-AKI remains unclear.

Methods

This multicenter retrospective cohort study used data from Medical Information Mart for Intensive Care IV (MIMIC-IV) database and eICU Collaborative Research Database (eICU-CRD). The Boruta algorithm, Kaplan-Meier method, and Cox proportional hazards model was used for the analysis.

Results

A total of 24,468 patients were included. The De Ritis ratio was significantly higher in deceased patients. The Boruta algorithm identifies it as an important predictor of mortality. Kaplan-Meier analysis showed higher mortality in the groups with elevated De Ritis ratios. Cox analysis indicated that it was a significant risk factor for mortality, with nonlinear associations found using RCS.

Conclusion

The De Ritis ratio is a significant and independent predictor of mortality in ICU patients with SA-AKI, highlighting its potential clinical utility in assessing prognosis and aiding in treatment decisions. Further prospective studies are required to confirm these findings.