Perbandingan Hubungan Rasio Neutrofil - Limfosit terhadap Rasio Neutrofil - Limfosit Platelet pada Kejadian Acute Kidney Injury (AKI) Pasien ICU Pascabedah Jantung Pusat Jantung Terpadu RS Adam Malik Medan

Abstract

Introduction: Hypoperfusion, ischemia-reperfusion injury, intravascular hemolysis, neurohumoral activation, inflammation, oxidative stress, nephrotoxins, and mechanical factors can cause postoperative AKI in CABG on-pump. A large body of literature has discussed inflammatory biomarkers and their relationship with CABG surgery. The neutrophil-lymphocyte ratio (RNL) and neutrophil-lymphocyte-platelet ratio (RNLP) can serve as biopredictors of inflammation following CABG surgery (p<0.05). High values of RNL and RNLP are associated with postoperative AKI and 5-year mortality. The RNLP ratio can help predict AKI and mortality in high-risk cardiovascular surgeries. Method: This is a retrospective analytical study aimed at comparing the neutrophil-lymphocyte ratio and the neutrophil-lymphocyte-platelet ratio with the incidence of AKI in ICU patients post-cardiac surgery at Adam Malik Hospital Medan. The study sample includes all ICU patients who underwent heart surgery between January 1, 2023, and December 31, 2023. After the data were collected, statistical analysis was conducted using SPSS. Results: There was a significant difference in RNL values in the AKI group (16.62 ± 10.2) compared to the non-AKI group (14,7612,61), with a p-value of 0.007, sensitivity of 57%, specificity of 44%, and a cutoff value of 17.10. There was also a significant difference in NLPR values in the AKI group (13,268,40) compared to the non-AKI group (9,9 ± 5,79), with a p-value of 0.013, sensitivity of 54%, specificity of 50.8%, and a cutoff value of 18,42. Conclusion: There is a significant relationship between RNL and NLPR values and Acute Kidney Injury.