ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurological Biomarkers
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1580248
Study on the Link Between Neutrophil Percentage to Albumin Ratio (NPAR) and Acute Kidney Injury in Severe Ischemic Stroke Patients During Hospitalization
Provisionally accepted
- General Hospital of the Chinese People's Liberation Army Western Theater, Chengdu, China
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Background: This study aimed to investigate the association between the neutrophil percentage-to-albumin ratio (NPAR) and the occurrence of acute kidney injury (AKI) in patients with severe ischemic stroke.Based on the EICU Clinical Research Database (EICU-CRD), 1,027 patients with severe ischemic stroke were enrolled (AKI group: 137 cases, non-AKI group: 890 cases). Data description: Non-normally distributed variables were expressed as median (IQR), and categorical variables were presented as frequency (weighted percentage). Statistical analysis: Intergroup comparisons were performed using the Wilcoxon rank-sum test and Rao-Scott chi-square test.Multivariate logistic regression and trend analysis were employed to evaluate the predictive value of NPAR for AKI, with adjustments for confounding factors.The AKI group exhibited significantly higher NPAR than the control group (29±10 vs. 24±7, P<0.001). 2. Risk prediction: After adjusting for confounding factors including liver function, electrolyte levels, blood cell count, history of renal insufficiency, furosemide use, and vital signs, NPAR remained an independent risk factor for AKI (OR=1.041,95% CI: 1.007-1.076, P-value= 0.0162).3. Dose-effect relationship: A significant increase in AKI risk was observed with each one-quarter increase in NPAR (Q4 vs Q1,OR:3.598,95%CI:1.482-9.12, P-value: 0.0056, P for trend: 0.0028) .4. Subgroup analysis:The impact of elevated NPAR on AKI risk was more pronounced in male patients.patients with severe ischemic stroke, demonstrating a clear dose-response relationship. These findings suggest that NPAR may serve as a potential biomarker.
Keywords: NPAR, ischemic stroke, Acute Kidney Injury, the EICU Clinical Research Database (EICU-CRD), Hospitalization
Received: 04 Jun 2025; Accepted: 27 Aug 2025.
Copyright: © 2025 Dong, Tang, Bai, Que, Bai, Huang, He and Pang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rizhao Pang, General Hospital of the Chinese People's Liberation Army Western Theater, Chengdu, China
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