Hematological Biomarkers in Sepsis-Associated Acute Kidney Injury
4 affiliations
- 1Assistant Professor of Internal Medicine and Nephrology, Faculty of Medicine - Zagazig University
- 2Professor of Internal Medicine and Nephrology, Faculty of Medicine - Zagazig University
- 3Resident of Internal Medicine, Faculty of Medicine - Zagazig University
- 4Lecturer of Internal Medicine, Faculty of Medicine - Zagazig University
Abstract
Background: Sepsis-associated acute kidney injury (SA-AKI) is a common and serious complication of sepsis. Monocyte distribution width (MDW), red blood cell distribution width (RDW), and the neutrophil-to-lymphocyte ratio (NLR) are simple blood count indices that may help identify renal risk. This study assessed their association with kidney deterioration and sepsis severity. Methods: This prospective study included 124 patients with sepsis admitted between April and September 2025. Sepsis-associated acute kidney injury (SA-AKI) was assessed by the Kidney Disease: Improving Global Outcomes (KDIGO) diagnostic criteria. Monocyte distribution width (MDW), red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), serum creatinine, blood urea nitrogen (BUN), inflammatory markers, and Sequential Organ Failure Assessment (SOFA) scores were evaluated at admission, with serial measurements performed through day 3. Results: Median MDW, RDW, NLR, and SOFA scores were 33.20, 15.36%, 21.75, and 8.00, respectively. Serum creatinine increased from 0.92 (0.80–1.04) mg/dL on day 1 to 3.83 (3.21–4.32) mg/dL on day 3 (P=0.001). Similarly, BUN increased from 16.60 (13.47–20.55) to 87.05 (56.15–103.12) mg/dL (P<0.001). Day-3 MDW showed the strongest reported correlation with SOFA score (r=0.650, P=0.011), followed by RDW (r=0.540, P=0.024) and NLR (r=0.320, P=0.024). Conclusion: Higher MDW, RDW, and NLR values were associated with renal dysfunction and sepsis severity, with MDW showing the strongest reported correlation with SOFA score. These readily available hematological indices may complement conventional renal assessment in patients with sepsis, although their clinical predictive value requires further validation.
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BibTeX
@article{goda2026hematological,
title = {{Hematological Biomarkers in Sepsis-Associated Acute Kidney Injury}},
author = {Tamer Goda and Adel Ghorab and Nafesa Kamal and Moaaz Asker and Fatma Elsayed},
journal = {Zagazig University Medical Journal},
year = {2026},
month = oct,
doi = {10.21608/zumj.2026.523497.4779},
url = {https://doi.org/10.21608/zumj.2026.523497.4779},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Hematological Biomarkers in Sepsis-Associated Acute Kidney Injury
AU - Tamer Goda
AU - Adel Ghorab
AU - Nafesa Kamal
AU - Moaaz Asker
AU - Fatma Elsayed
PY - 2026
DA - 2026/10/25
JO - Zagazig University Medical Journal
DO - 10.21608/zumj.2026.523497.4779
UR - https://doi.org/10.21608/zumj.2026.523497.4779
AB - Background: Sepsis-associated acute kidney injury (SA-AKI) is a common and serious complication of sepsis. Monocyte distribution width (MDW), red blood cell distribution width (RDW), and the neutrophil-to-lymphocyte ratio (NLR) are simple blood count indices that may help identify renal risk. This study assessed their association with kidney deterioration and sepsis severity. Methods: This prospective study included 124 patients with sepsis admitted between April and September 2025. Sepsis-associated acute kidney injury (SA-AKI) was assessed by the Kidney Disease: Improving Global Outcomes (KDIGO) diagnostic criteria. Monocyte distribution width (MDW), red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), serum creatinine, blood urea nitrogen (BUN), inflammatory markers, and Sequential Organ Failure Assessment (SOFA) scores were evaluated at admission, with serial measurements performed through day 3. Results: Median MDW, RDW, NLR, and SOFA scores were 33.20, 15.36%, 21.75, and 8.00, respectively. Serum creatinine increased from 0.92 (0.80–1.04) mg/dL on day 1 to 3.83 (3.21–4.32) mg/dL on day 3 (P=0.001). Similarly, BUN increased from 16.60 (13.47–20.55) to 87.05 (56.15–103.12) mg/dL (P<0.001). Day-3 MDW showed the strongest reported correlation with SOFA score (r=0.650, P=0.011), followed by RDW (r=0.540, P=0.024) and NLR (r=0.320, P=0.024). Conclusion: Higher MDW, RDW, and NLR values were associated with renal dysfunction and sepsis severity, with MDW showing the strongest reported correlation with SOFA score. These readily available hematological indices may complement conventional renal assessment in patients with sepsis, although their clinical predictive value requires further validation.
SN - 2357-0717
SN - 1110-1431
ER -