Association between serum glucose/potassium ratio and acute kidney injury in patients with traumatic brain injury: based on MIMIC-IV database

Background: Acute kidney injury (AKI) is a common complication in patients with traumatic brain injury (TBI) and is closely linked to prognosis. Although the serum glucose-to-potassium ratio (GPR) is a prognostic indicator in various diseases, its clinical significance in this specific patient population remains unexplored. Methods: We identified patients requiring intensive care unit admission from the critical care medical information database and stratified them into quintiles based on GPR. The nonlinear relationship between GPR and AKI in TBI patients was analysed by restricted cubic splines (RCS). We conducted an exploratory subgroup analysis to investigate the differences in this association across different subgroups. Using mediation analysis, we aimed to explore the potential mediating effect of fluid balance in the development of AKI in patients with GPR and TBI. Results: , P < 0.001). Conclusions: GPR is significantly associated with AKI risk in TBI patients, which may be mediated by FB. We identified GPR as a new biomarker for assessing AKI risk in TBI patients, thereby offering fresh insights into prevention and treatment for this population.