Combining RAR with the lactate-to-albumin ratio (LAR) significantly enhanced predictive accuracy (AUC: 0.777; 95% CI: 0.703-0.851; <i>p</i> = 0.043 vs. RAR alone).<h4>Conclusion</h4>Elevated RAR independently predicts adverse early prognosis in SA-AKI, with higher levels correlating with increased 28-day mortality. This evidence concerns the gene ALB and acute kidney injury.