Association between blood urea nitrogen-to-potassium ratio trajectories and MAKE-30 risk in critically patients with non-traumatic subarachnoid hemorrhage

This study investigates the association between short-term longitudinal blood urea nitrogen-to-potassium ratio (BPR) trajectories and the risk of major adverse kidney events within 30 days (MAKE-30) in patients with non-traumatic subarachnoid hemorrhage (n-SAH). This study used Latent Class Growth Modeling to identify BPR trajectories and applied Kaplan-Meier curves and Cox regression to assess their association with outcomes like MAKE‑30 and acute kidney injury (AKI). The research subjects included 476 patients with n-SAH, and three different BPR trajectory patterns were identified. Kaplan-Meier curves demonstrated that Class 3 patients exhibited significantly lower survival rates for MAKE-30, AKI, 30-day, 90-day, 180-day, and 365-day mortality compared to other trajectory groups (all P < 0.0001). Consistently, multivariable Cox regression analysis demonstrated that patients in Class 3 remained significantly associated with higher risks of both MAKE-30 (HR = 2.59, 95% CI: 1.03 ~ 6.48, P = 0.043) and AKI (HR = 14.43, 95% CI: 6.18 ~ 33.7, P < 0.001). This association was more pronounced in subgroups, including patients over 65, those with diabetes, and those not treated with CCB, who showed a significantly higher risk of MAKE-30 (all P < 0.01). The study suggests that persistently high BPR levels are significantly associated with an elevated risk of MAKE-30.