Lactate and lactylation in sepsis-associated acute kidney injury: clinical evidence from the MIMIC-IV database and mechanistic insights

Elevated lactate levels are independently associated with increased risk of SA-AKI in sepsis patients, whereas higher lactate clearance is linked to improved renal outcomes. Moreover, kidney-specific upregulation of protein lactylation in septic mice suggests a possible molecular link between lactate metabolism and renal vulnerability. These findings highlight lactate and lactylation as both prognostic markers and potential mechanistic contributors in SA-AKI.