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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

A Multidomain Biomarker Score for Predicting Acute Kidney Injury and Renal Replacement Therapy Initiation in Critically Ill Adults

  • Semih Aydemir1
  • Yavuz Kutay Gökçe2
  • Doğukan Şenberber3
  • Temel Kayan4
  • Yavuz Katırcı5
  • Dilber Kumral1
  • Gamze Kılıçarslan1
  • Onur Küçük3
  • Fatih Segmen6
  • Recep Dokuyucu7
7 affiliations
  1. 1Department of Anesthesiology and Reanimation, Yıldırım Beyazıt University Yenimahalle Training and Research Hospital, 06370 Ankara, Türkiye
  2. 2Department of Internal Medicine, Yıldırım Beyazıt University Yenimahalle Training and Research Hospital, 06370 Ankara, Türkiye
  3. 3Department of Anesthesiology and Reanimation, School of Medicine, Dokuz Eylül University, 35330 İzmir, Türkiye
  4. 4Department of Intensive Care Unit, Ankara City Hospital, University of Health Sciences, 06800 Ankara, Türkiye
  5. 5Department of Emergency Medicine, Health Sciences University Gülhane Training and Research Hospital, 06010 Ankara, Türkiye
  6. 6Department of Critical Care, Health Sciences University Ankara Bilkent City Hospital, 06800 Ankara, Türkiye
  7. 7Department of Physiology, Medical Specialization Training Center (TUSMER), 06420 Ankara, Türkiye
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Abstract

Background/Objectives: We evaluated the Renal–Inflammatory–Nutritional–Metabolic Index (RIN-IM), a previously published 0–10-point composite biomarker score, for acute kidney injury (AKI) and renal replacement therapy (RRT) initiation in an independent intensive care unit (ICU) cohort. Methods: This retrospective study included 480 adults admitted to two ICUs between October 2023 and August 2026. RIN-IM was calculated within 24 h of admission from creatinine, albumin, systemic immune-inflammation index (platelet count × neutrophil count/lymphocyte count), pan-immune-inflammation value (neutrophil count × platelet count × monocyte count/lymphocyte count), and triglyceride–glucose index (triglyceride and admission glucose concentrations). Patients were classified by RIN-IM Score as low-risk (0–3 points), intermediate-risk (4–6 points), or high-risk (7–10 points). Among patients without AKI or acute RRT initiation at or before the 24-h landmark, subsequent incident AKI was the primary outcome and RRT initiation was the secondary renal outcome. Twenty-eight-day all-cause mortality was evaluated descriptively. Logistic regression and receiver operating characteristic analyses were performed. Results: AKI occurred in 189 patients (39.4%), RRT was initiated in 72 (15.0%), and 157 (32.7%) died within 28 days. In the low-, intermediate-, and high-risk groups, AKI frequencies were 16.0%, 40.0%, and 62.0%; RRT initiation frequencies were 3.3%, 12.2%, and 30.0%; and 28-day mortality was 18.0%, 32.2%, and 48.0%, respectively (all p < 0.001). Adjusted odds ratios per score point was 1.31 (95% confidence interval, 1.16–1.48) for AKI and 1.47 (1.25–1.73) for RRT initiation. Areas under the curve were 0.862 and 0.903, respectively, exceeding those of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment. Conclusions: Higher RIN-IM scores were associated with AKI, RRT initiation, and higher observed 28-day mortality. The score may support early renal risk stratification, pending prospective assessment of calibration and clinical utility.

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Cite

BibTeXRIS
BibTeX
@article{aydemir2026multidomain,
  title = {{A Multidomain Biomarker Score for Predicting Acute Kidney Injury and Renal Replacement Therapy Initiation in Critically Ill Adults}},
  author = {Semih Aydemir and Yavuz Kutay Gökçe and Doğukan Şenberber and Temel Kayan and Yavuz Katırcı and Dilber Kumral and Gamze Kılıçarslan and Onur Küçük and Fatih Segmen and Recep Dokuyucu},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218351},
  url = {https://www.mdpi.com/2077-0383/15/21/8351},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - A Multidomain Biomarker Score for Predicting Acute Kidney Injury and Renal Replacement Therapy Initiation in Critically Ill Adults
AU  - Semih Aydemir
AU  - Yavuz Kutay Gökçe
AU  - Doğukan Şenberber
AU  - Temel Kayan
AU  - Yavuz Katırcı
AU  - Dilber Kumral
AU  - Gamze Kılıçarslan
AU  - Onur Küçük
AU  - Fatih Segmen
AU  - Recep Dokuyucu
PY  - 2026
DA  - 2026/10/27
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218351
UR  - https://www.mdpi.com/2077-0383/15/21/8351
AB  - Background/Objectives: We evaluated the Renal–Inflammatory–Nutritional–Metabolic Index (RIN-IM), a previously published 0–10-point composite biomarker score, for acute kidney injury (AKI) and renal replacement therapy (RRT) initiation in an independent intensive care unit (ICU) cohort. Methods: This retrospective study included 480 adults admitted to two ICUs between October 2023 and August 2026. RIN-IM was calculated within 24 h of admission from creatinine, albumin, systemic immune-inflammation index (platelet count × neutrophil count/lymphocyte count), pan-immune-inflammation value (neutrophil count × platelet count × monocyte count/lymphocyte count), and triglyceride–glucose index (triglyceride and admission glucose concentrations). Patients were classified by RIN-IM Score as low-risk (0–3 points), intermediate-risk (4–6 points), or high-risk (7–10 points). Among patients without AKI or acute RRT initiation at or before the 24-h landmark, subsequent incident AKI was the primary outcome and RRT initiation was the secondary renal outcome. Twenty-eight-day all-cause mortality was evaluated descriptively. Logistic regression and receiver operating characteristic analyses were performed. Results: AKI occurred in 189 patients (39.4%), RRT was initiated in 72 (15.0%), and 157 (32.7%) died within 28 days. In the low-, intermediate-, and high-risk groups, AKI frequencies were 16.0%, 40.0%, and 62.0%; RRT initiation frequencies were 3.3%, 12.2%, and 30.0%; and 28-day mortality was 18.0%, 32.2%, and 48.0%, respectively (all p < 0.001). Adjusted odds ratios per score point was 1.31 (95% confidence interval, 1.16–1.48) for AKI and 1.47 (1.25–1.73) for RRT initiation. Areas under the curve were 0.862 and 0.903, respectively, exceeding those of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment. Conclusions: Higher RIN-IM scores were associated with AKI, RRT initiation, and higher observed 28-day mortality. The score may support early renal risk stratification, pending prospective assessment of calibration and clinical utility.
SN  - 2077-0383
ER  -