Is there a relationship between renal scarring and neutrophil-to-lymphocyte ratio in patients with vesicoureteral reflux?

Abstract

Objectives: Vesicoureteral reflux (VUR) exacerbates the risk of renal scarring by establishing a ground for pyelonephritis. It is known that the inflammatory process is more influential than the direct damage caused by bacterial infection in the development of renal scars after pyelonephritis. Therefore, the present study aims to investigate the relationship between renal scarring and systemic inflammatory markers in patients with VUR.Material and methods: Hundred and ninety-two patients (116 females, 76 males) diagnosed with VUR were divided into two groups based on the presence or absence of renal scarring and into three groups according to the grade of VUR (low, moderate and high). Neutrophil count, lymphocyte count, mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) were compared among the groups.Results: Of the 192 patients, 102 had renal scarring. The age and gender distribution did not differ significantly between the groups with and without renal scarring (p > 0.05). However, the grade of reflux and lymphocyte count were significantly higher in the group with renal scarring (p < 0.05), and the NLR was significantly lower in the group with renal scarring (p < 0.05). The lymphocyte count was significantly higher (p < 0.05) and NLR was significantly lower in the high-grade VUR group (p < 0.05). However, MPV values did not differ significantly (p > 0.05) between the groups. Conclusions: NLR can be used to predict renal scarring in patients with VUR, especially in the period of 3-6 months after the first attack of infection, and may even serve as a candidate marker for treatment selection. However, larger series and prospective studies are needed.

Effect of Haematological Parameters in the Development of Urethrocutaneous Fistula After Hypospadias Surgery

“…This has led researchers to investigate other factors. In recent years, inflammatory markers have played an important role in predicting the prognosis of malignancy, cardiovascular diseases, scar development in vesicoureteral reflux and rheumatic diseases [7,8]. In the present study, we focused on whether pre-operative haematological parameters affected UCF development.…”

Diagnostic Value of the Systemic Immune-Inflammation Index in Newborns with Urinary Tract Infection

“…35 Recently, Demir et al showed that higher NLR values (1.16 ± 0.70) might predict renal scarring in patients with VUR, especially within the period of 3 to 6 months after the first attack of infection. 36 On the other hand, Zheng et al 37 also assessed the prognostic value of PLR in critically ill patients with acute kidney injury; they found that both low and high PLRs were associated with increased mortality. In our study, we also used hematological indices to define renal involvement in newborns with UTI.…”