Nazım Abdülkadir KANKILIÇ, Ekrem Taha SERT, Kamil KOKULU
Eurasian Journal of Emergency Medicine - 2026;25(1):222-227
Aim: Acute renal infarction (ARI) is an uncommon but clinically important vascular emergency that is frequently misdiagnosed as acute ureterolithiasis due to overlapping symptoms. This study aimed to evaluate the diagnostic value of the lactate dehydrogenase-to-albumin (LDH/albumin) ratio in patients with ARI. Materials and Methods: This study included adult patients diagnosed with ARI between January 2018 and June 2025. ARI was confirmed using contrast-enhanced computed tomography. A control group of patients with acute ureterolithiasis was selected using 2:1 propensity score matching on age and sex. Demographic variables, clinical features, and laboratory parameters were compared. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of ARI. Diagnostic performance was assessed using ROC curve analysis. Results: A total of 162 patients were included, comprising 54 with ARI and 108 with ureterolithiasis. Patients with ARI showed significantly higher LDH levels and LDH/albumin ratios, and lower albumin levels compared with controls. The LDH/albumin ratio demonstrated the strongest association with ARI [odds ratio=3.62; 95% confidence interval (CI): 1.96-6.58]. ROC analysis showed that the LDH/albumin ratio [area under the curve (AUC)=0.921; 95% CI: 0.881-0.963) had superior diagnostic performance compared with LDH (AUC=0.873) and albumin (AUC=0.780). A cut-off value >13.1 yielded a sensitivity of 85.2% and a specificity of 83.3% for identifying ARI. Conclusion: The LDH/albumin ratio demonstrates superior diagnostic performance compared with LDH or albumin alone because it reflects both tissue ischemia and inflammatory processes. Therefore, it may serve as a valuable and readily accessible biomarker for the early identification of ARI.
