SP245
Increased delta neutrophil index is associated with in hospital renal survival and mortality in alcoholic ketoacidosis patients

INTRODUCTION: Alcoholic ketoacidosis (AKA) is known as a benign disease, but the related mortality reported in Korea is high. We aimed to evaluate the use of DNI and other standard laboratory parameters as predictors of prognosis in AKA patients.

METHODS: One hundred eighteen males with AKA were evaluated at the Wonju Severance Christian hospital between 2009 and 2014. We performed a retrospective analysis of demographic, clinical, and laboratory parameters data. Receiver operating characteristic curves (ROC) and multivariate Cox regression were used to identify renal survival and mortality.

RESULTS: Survival patients had lower initial DNI levels than non-survival patients (4.8±6.4 vs 11.4±12.5, p<0.001). In multivariate-adjusted Cox regression analysis, higher initial increased DNI (HR 1.044, 95% CI 1.003-1.086, p=0.035), and lower initial pH (HR 0.044, 95% CI 0.004-0.452, p=0.008) were risk factors for dialysis during hospitalization. Further, higher initial DNI level (HR 1.037; 95% CI 1.006-1.069; p=0.018), lower initial pH (HR 0.049; 95% CI 0.008-0.312; p=0.001) and lower initial glomerular filtration rate (GFR) (HR 0.981; 95% CI 0.964-0.999; p=0.033) were predictors of mortality.

Table. Cut-off values of parameters predicting mortality by ROC curve analysis.

Figure. Kaplan-Meier plots for cumulative renal survival during hospital days.

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CONCLUSIONS: Increased initial serum DNI levels may help to predict renal survival and prognosis in male AKA patients and this is a cost-effective and simple method.