{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:00:34Z","timestamp":1785128434734,"version":"3.55.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sepsis-associated acute kidney injury (SA-AKI) is heterogeneous in severity and biological drivers. Early identification of clinically significant SA-AKI remains challenging because conventional severity markers and kidney-function criteria do not fully capture metabolic stress, inflammatory-coagulopathy burden, and host-reserve\/catabolic-inflammatory status. We evaluated whether a routinely available prealbumin-containing TyG\u2013FPR\u2013AISI composite provides incremental risk-stratification value for clinically significant early SA-AKI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective derivation cohort included 359 septic ICU patients between January 2018 and December 2024. The primary endpoint was clinically significant early SA-AKI within 48 h after T0, defined as serum creatinine-defined KDIGO stage 2\u20133 AKI or renal-indication RRT\/CRRT. Patients without the primary endpoint and with &amp;lt; 48 h of ICU observation were excluded from the main analysis, yielding 325 patients. TyG, fibrinogen-to-prealbumin ratio (FPR), and aggregate index of systemic inflammation (AISI) were measured within 0\u201324 h after T0. An equal-weight composite was calculated as the mean of standardized TyG, FPR, and AISI. Logistic regression, ROC analysis, fivefold cross-validation, calibration assessment, Brier score, decision curve analysis, and sensitivity analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinically significant early SA-AKI occurred in 69 of 325 patients (21.2%). FPR was independently associated with the primary endpoint (adjusted OR 1.36 per 1-SD increase, 95% CI 1.05\u20131.76), whereas TyG and AISI showed directionally positive but weaker associations. The equal-weight composite was independently associated with clinically significant early SA-AKI (adjusted OR 1.58 per 1-SD increase, 95% CI 1.20\u20132.07). Model 0 plus the composite improved apparent AUC from 0.671 to 0.706 and fivefold cross-validated AUC from 0.608 to 0.653, with a lower Brier score (0.147 vs. 0.155). Higher composite tertiles were associated with more severe KDIGO categories and persistent AKI at day 7. Sensitivity analyses supported the composite association for any-stage creatinine-defined SA-AKI, while associations were attenuated when urine-output criteria were incorporated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prealbumin-containing TyG\u2013FPR\u2013AISI composite was associated with clinically significant early SA-AKI and short-term AKI persistence, but its incremental performance beyond a clinical baseline model was modest. These findings support its exploratory role as a routinely available nutrition-relevant host-response risk-enrichment signal rather than a stand-alone prediction tool; external validation and recalibration are required before clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1825792","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T04:25:44Z","timestamp":1785126344000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A prealbumin-containing TyG\u2013FPR\u2013AISI composite for clinically significant early sepsis-associated acute kidney injury: a single-center derivation cohort study with internal validation"],"prefix":"10.3389","volume":"13","author":[{"given":"Yang","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinkui","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sensheng","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Urology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangyang","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuni","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luhao","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lie","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Patient Relations, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University","place":["Huai'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1038\/s41581-023-00683-3","article-title":"Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup","volume":"19","author":"Zarbock","year":"2023","journal-title":"Nat Rev Nephrol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1007\/s00134-023-07138-0","article-title":"Sepsis-associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. 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