Neutrophil/lymphocyte ratio: A promising prognostic marker in patients with chronic kidney disease

Kato, Shinichi; Abe, Tomoko; Lindholm, Bengt; Maruyama, Shoichi

doi:10.14800/ics.683

Cited by 3 publications

(1 citation statement)

References 47 publications

(53 reference statements)

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“…The link between systemic inflammation and short-term AVF failure has been recently studied [15][16][17][18][19]. Among the recently most studied inflammatory markers in the literature, we mention the neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) as having predictive roles in the negative evolution of patients with a cardiovascular pathology [20][21][22][23][24][25][26][27][28] and patients with chronic kidney disease (CKD), respectively [17,18,[29][30][31][32][33]. Another typical inflammatory marker is the systemic inflammatory index (SII), which predicts mortality and poor oncological pathology outcomes [34][35][36].…”

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confidence: 99%

The Predictive Value of Systemic Inflammatory Markers, the Prognostic Nutritional Index, and Measured Vessels’ Diameters in Arteriovenous Fistula Maturation Failure

Kaller

Arbănași²,

Mureșan

et al. 2022

Life

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Background: An arteriovenous fistula (AVF) is the first-line vascular access pathway for patients diagnosed with end-stage renal disease (ESRD). In planning vascular access, it is necessary to check the diameters of the venous and arterial components for satisfactory long-term results. Furthermore, the mechanism underlying the maturation failure and short-term patency in cases of AVFs is not fully known. This study aims to verify the predictive role of inflammatory biomarkers (the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic inflammatory index (SII), and C-reactive protein (CRP)), Ca-P product, the prognostic nutritional index (PNI), and the diameters of the venous and arterial components in the failure of AVF maturation. Methods: The present study was designed as an observational, analytical, and retrospective cohort study with a longitudinal follow-up, and included all patients with a diagnosis of ESRD that were admitted to the Vascular Surgery Clinic of the Targu Mures Emergency County Hospital, Romania, between January 2019 and December 2021. Results: The maturation of AVF at 6 weeks was clearly lower in cases of patients in the high-NLR (31.88% vs. 91.36%; p < 0.0001), high-PLR (46.94% vs. 85.55%; p < 0.0001), high-SII (44.28% vs. 88.89%; p < 0.0001), high-CRP (46.30% vs. 88.73%; p < 0.0001), high-Ca-P product (40.43% vs. 88.46%; p < 0.0001), and low-PNI (34.78% vs. 91.14%; p < 0.0001) groups, as well as in patients with a lower radial artery (RA) diameter (40% vs. 94.87%; p = 0.0009), cephalic vein (CV) diameter (44.82% vs. 97.14%; p = 0.0001) for a radio-cephalic AVF (RC-AVF), and brachial artery (BA) diameter (30.43% vs. 89.47%; p < 0.0001) in addition to CV diameter (40% vs. 94.59%; p < 0.0001) for a brachio-cephalic AVF (BC-AVF), respectively. There was also a significant increase in early thrombosis and short-time mortality in the same patients. A multivariate analysis showed that a baseline value for the NLR, PLR, SII, CRP, Ca-P product, and PNI was an independent predictor of adverse outcomes for all of the recruited patients. Furthermore, for all patients, a high baseline value for vessel diameter was a protective factor against any negative events during the study period, except for RA diameter in mortality (p = 0.16). Conclusion: Our findings concluded that higher NLR, PLR, SII, CRP, Ca-P product, and PNI values determined preoperatively were strongly predictive of AVF maturation failure, early thrombosis, and short-time mortality. Moreover, a lower baseline value for vessel diameter was strongly predictive of AVF maturation failure and early thrombosis.

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Section: Introductionmentioning

confidence: 99%

The Predictive Value of Systemic Inflammatory Markers, the Prognostic Nutritional Index, and Measured Vessels’ Diameters in Arteriovenous Fistula Maturation Failure

Kaller

Arbănași²,

Mureșan

et al. 2022

Life

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Neutrophil-Lymphocyte Ratio (NLR) Reflects Myocardial Inhomogeneities in Hemodialyzed Patients

Bołtuć

Bociek

Dziugieł

et al. 2020

Mediators of Inflammation

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Introduction. Cardiovascular diseases (CVDs) are a leading cause of death in chronically hemodialyzed (HD) patients. In this group, inflammation exerts significant impact on the prevalence of CVD morbidity and mortality. Spatial QRS-T angle is an independent and strong predictor of CV events, including sudden cardiac death (SCD), both in general population and HD patients. Pathogenesis of widened QRS-T angle is complicated and is not well established. Objectives. The study is aimed at evaluating whether inflammation process can contribute to the wide QRS-T angle. Patients and Methods. The retrospective study was performed on 183 HD patients. The control group consisted of 38 patients. Demographic, biochemical, vectorcardiographic, and echocardiographic data were evaluated in all patients. Inflammation process was expressed as neutrophil-lymphocyte ratio (NLR), as well as C-reactive protein (CRP). Results. Both NLR (3.40 vs. 1.95 (p<0.0001)) and spatial QRS-T angle (50.76 vs. 93.56 (p<0.001)) were higher in the examined group, compared to the control group. Similarly, CRP was higher in the examined group than in the control group (8.35 vs. 4.06 (p<0.001), respectively). The QRS-T angle correlated with NLR, CRP, some structural echocardiographic parameters, parathormone (PTH), and calcium (Ca) concentrations. Multiple regression analysis showed that NLR is an independent QRS-T angle predictor (r=0.498, p=0.0027). The ROC curve analysis indicated the cut-off point of NLR equaled 4.59, where the sensitivity and specificity were the highest for predicting myocardial inhomogeneities expressed as widened QRS-T angle. Conclusion. The NLR, as an inflammation marker, may indicate myocardial inhomogeneities in HD patients.

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Correlation of lymphocyte count with serum calcium level and neutrophil-to-lymphocyte ratio in end stage renal disease patients undergoing hemodialysis in Adamawa State, Nigeria

Etim¹,

Emokpae²,

Medugu³

et al. 2017

Int. J. Med. Med. Sci.

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Low lymphocyte count in end stage renal disease (ESRD) patients receiving maintenance hemodialysis was documented. This study aims to correlate the levels of lymphocyte count with serum calcium level, and neutrophil-to-lymphocyte ratio (NLR) in ESRD patient receiving hemodialysis in Northeast Nigeria. Seventy eight (78) patients receiving hemodialysis and 75 clinically healthy subjects (control) participated in the present study. Full blood count and serum calcium level were determined by using a Sysmex XP-300 Hematology Analyzer and a Selectra Pro-S Chemistry Analyzer, respectively. The mean levels of lymphocyte count, packed cell volume, hemoglobin and serum calcium level were significantly lower (p<0.001), while neutrophil, and NLR values were significantly higher (p<0.001) in ESRD patients undergoing hemodialysis as compared to the healthy control subjects. Lymphocyte count was negatively correlated with NLR value (r=-0.341; 0.05) but positively with serum calcium (r=0.904; p<0.001). In end stage renal disease (ESRD) patient receiving hemodialysis, lymphocyte count was negatively correlated with NLR value and positively with serum calcium level.

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Neutrophil/lymphocyte ratio: A promising prognostic marker in patients with chronic kidney disease

Cited by 3 publications

References 47 publications

The Predictive Value of Systemic Inflammatory Markers, the Prognostic Nutritional Index, and Measured Vessels’ Diameters in Arteriovenous Fistula Maturation Failure

The Predictive Value of Systemic Inflammatory Markers, the Prognostic Nutritional Index, and Measured Vessels’ Diameters in Arteriovenous Fistula Maturation Failure

Neutrophil-Lymphocyte Ratio (NLR) Reflects Myocardial Inhomogeneities in Hemodialyzed Patients

Correlation of lymphocyte count with serum calcium level and neutrophil-to-lymphocyte ratio in end stage renal disease patients undergoing hemodialysis in Adamawa State, Nigeria

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