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This study retrospectively analyzed 798 AP patients admitted within three days of onset and divided them into a PRF group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009111) and a non-PRF group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009687), comparing the characteristics of the two groups. Multivariate analysis showed that lactate (\u03b2\u2009=\u20090.340,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001, OR\u2009=\u20091.405) and lactate dehydrogenase (LDH, \u03b2\u2009=\u20090.002,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001, OR\u2009=\u20091.002) were significant risk factors for PRF. Stratified analysis indicated that patients with LDH\u2009\u2265\u2009700 U\/L and lactate\u2009\u2265\u20092\u00a0mmol\/L had a higher incidence of PRF. The ROC curve analysis showed that the areas under the curve for lactate, LDH, and the combined lactate\u2009+\u2009LDH were 0.752, 0.828, and 0.866, respectively, with the highest diagnostic accuracy for the combined indicator. The characteristics of different risk groups showed that the incidence of PRF in the high-risk group was significantly higher than that in the low-risk group. The levels of lactate and LDH within 24\u00a0h of admission have a significant predictive effect on PRF in AP patients, which helps clinicians identify high-risk patients early and guide treatment decisions.\n                  <\/jats:p>","DOI":"10.1186\/s12876-025-04413-w","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:55:04Z","timestamp":1763412904000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early lactate and its metabolism for predicting persistent renal failure in patients with acute pancreatitis: a retrospective observational study"],"prefix":"10.1186","volume":"25","author":[{"given":"Jianhua","family":"Wan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huajing","family":"Ke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhua","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nonghua","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"issue":"6","key":"4413_CR1","doi-asserted-by":"publisher","first-page":"1252","DOI":"10.1053\/j.gastro.2013.01.068","volume":"144","author":"D Yadav","year":"2013","unstructured":"Yadav D, Lowenfels AB. 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Informed consent by verbal was obtained from all participants approved by the ethics committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication:"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"811"}}