Lactate and lactylation in sepsis-associated acute kidney injury: clinical evidence from the MIMIC-IV database and mechanistic insights.

ABSTRACT:

Background

Sepsis-associated acute kidney injury (SA-AKI) is a common and severe complication of sepsis, yet early predictors remain limited. Lactate, beyond being a marker of tissue hypoperfusion, may act as a signaling molecule through protein lactylation. This study aimed to investigate the association between lactate levels and SA-AKI risk using the MIMIC-IV database and to explore the potential mechanistic role of lactylation in septic mice.

Methods

Adult sepsis patients were identified from the MIMIC-IV (v3.1) database. Patients were stratified by lactate tertiles within 24 h of ICU admission, and lactate clearance (LC) was assessed as a dynamic indicator. The primary outcome was SA-AKI, and secondary outcomes included CRRT use and 28-day mortality. Kaplan-Meier analys

SUBMITTER: Zhang S 

PROVIDER: S-EPMC12660216 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature