Serum Fibrinogen to Serum Albumin Ratio as a prognostic Factor among Acute Kidney Injury Patients

Elnaggar, Ashraf Khalifa; Ali, Mahmoud Mohammed Ragab; Ahmed, Azza Moustafa; Abdelrahman, Essam Adel

doi:10.21608/zumj.2025.398280.4024

Serum Fibrinogen to Serum Albumin Ratio as a prognostic Factor among Acute Kidney Injury Patients

Document Type : Original Article

Authors

¹ Professor of Internal Medicine, Faculty of Medicine - Zagazig University

² MBBCH, Faculty of Medicine - Zagazig University

³ Assistant Professor of Clinical Pathology, Faculty of Medicine - Zagazig University

⁴ Lecturer of Internal Medicine, Faculty of Medicine - Zagazig University

10.21608/zumj.2025.398280.4024

Abstract

Background: Acute kidney injury (AKI) is considered occurs frequently among the ICU patients, leading to longer hospital stays, more complications, as well as mortality. Inflammation plays significant role in AKI, the fibrinogen to albumin ratio (FAR), is an inflammation marker that could help in prediction of outcomes among these patients. We aimed in this work to assess the prognostic role of FAR for prediction of the hospital mortality among critically ill patients who had AKI.

Methods: This prospective cohort study was conducted on 120 adults who had AKI who were admitted to the ICU, we collected their medical history, laboratory investigations included fibrinogen and albumin levels, and calculated FAR, the Simplified Acute Physiology Score (SAPS), as well as Sequential Organ Failure Assessment (SOFA) scores. We tracked whether patients got discharged or died during their ICU stay.

Results: FAR was positively linked to SOFA and SAPS II scores, as well as other laboratory markers. The ROC curve showed FAR had a strong ability to predict death, with an AUC of 0.856 at a cut-off of 0.79. In multivariate logistic regression analysis, FAR was identified as a significant independent predictor of mortality (odds ratio [OR] 1.36, 95% CI 1.48–1.52, P<0.001), along with other factors such as smoking (OR 3.04, 95% CI 1.29–7.16, P=0.01) and congestive heart failure (OR 3.06, 95% CI 1.26–7.43, P=0.01).

Conclusion: An elevated FAR has been linked to increase in hospital mortality in critically ill patients with AKI, suggesting its potential utility as a prognostic indicator among these patients.

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