Neutrophil-to-Lymphocyte Ratio as a Predictor of Worsening Renal Function in Diabetic Patients (3-Year Follow-Up Study)

Abstract

Background: Previous studies have demonstrated the role of inflammation in diabetic nephropathy (DN). Neutrophil to lymphocyte ratio (NLR) rather than other white cell parameters was found to be a useful inflammatory marker to predict adverse outcomes in medical and surgical conditions. Nevertheless, the value of NLR in predicting DN has not been elucidated. Method: An observational study included 338 diabetic patients, who were followed at our clinic between 2007 and 2009. We arranged our patients into tertiles according to their 2007 NLR. The primary outcome was continuous decrease of GFR >12 mL/min between 2007 and 2009 with the last GFR <60 mL/min. Result: The lowest NLR tertile had fewer patients (2.7%) with primary outcome (i.e., worsening renal function) compared with middle and highest NLR tertiles, which had more patients with primary outcomes (8.7% and 11.5%, respectively) with a significant p-value 0.0164. When other potential confounders were individually analyzed with NLR tertile, the NLR tertiles remained a significant predictor of poor GFR outcome in the presence of other variables (hemoglobin A1C, systolic blood pressure, diastolic blood pressure, age, and congestive heart failure with p-values 0.018, 0.019, 0.017, 0.033, and 0.022, respectively). Conclusion: NLR predicted the worsening of the renal function in diabetic patients. Further studies are needed to confirm this result.

Neutrophil-lymphocyte ratio in small renal masses.

“…In terms of medical comorbidities, there was no significant difference in preoperative NLR values between patients with low or high ASA scores; however, worse preoperative renal function was associated with higher preoperative NLR. This latter association is in concordance with the medical literature and reflects the systemic inflammatory response with renal failure [21][22][23].…”

“…The easily calculated NLR, on the other hand, has shown utility as an alternative marker of systemic inflammation in critically ill patients [19], malignancies [20], and chronic medical conditions such as end-stage renal disease and diabetes [21][22][23]. Our study's goal was to determine whether preoperative NLR can be incorporated in preoperative decision making for patients with small renal masses, as 20% of those masses prove benign after surgery [24].…”

Neutrophil:lymphocyte ratio is positively related to type 2 diabetes in a large-scale adult population: a Tianjin Chronic Low-Grade Systemic Inflammation and Health cohort study

“…One review article also indicated that NLR has been related to arterial stiffness and high coronary calcium scores, which are significant markers of CVD (34). Recently, NLR has been reported to be a prognostic marker for outcomes that result from diabetic retinopathy (35), including microvascular complications (36) and impaired renal function (37). Although the precise mechanisms that underlie the associations between systemic inflammation and prevalent conditions remain to be elucidated, these studies verify the present conclusion that NLR could be used as an innovative and effective predictor for T2D.…”

Peritonitis Incidence Was Correlated with Duration of Peritoneal Dialysis Rather than Leptin or Neutrophil to Lymphocyte (N/L) Ratio in Peritoneal Dialysis Patients

“…Bulgular: Hasta grubunda ölçülen serum leptin düzeyi control grubundan istatistiksel olarak anlamlı yüksek bulundu (1624.88±1608. 16 and 416±439.85). Hesaplanan peritonit insidansı 0.041±0.047 peritoniti/ hasta yılı olarak bulundu.…”