Neutrophil to Lymphocyte Ratio in Evaluation of Inflammation in Patients with Chronic Kidney Disease

Okyay, Gülay Ulusal; İnal, Salih; Öneç, Kürşad; Er, Ramazan Erdem; Paşaoğlu, Özge Tuğçe; Paşaoğlu, Hatîce; Derici, Ülver; Erten, Yasemin

doi:10.3109/0886022x.2012.734429

Cited by 170 publications

(155 citation statements)

References 27 publications

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“…They release several types of cytokines and trigger the immune system and infl ammatory reactions. Previous studies have demonstrated that higher levels of NLR are associated with impaired cardiovascular outcomes (10)(11)(12)(13). NLR is not only associated with CVD, but also associated with chronic renal disease and several malignancies (11,13,29,30).…”

Section: Discussionmentioning

confidence: 99%

“…The neutrophil to lymphocyte ratio (NLR) which can be derived from the white blood cell count is an inexpensive, routinely used, reproducible test. NLR has been proposed as a novel biomarker for systemic infl ammatory response in several diseases (10)(11)(12)(13). Previous studies have shown that NLR is associated with poor clinical outcomes in CVD and it is also a predictor for CVD (10,12).…”

Section: Introductionmentioning

confidence: 99%

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The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

Sünbül¹,

Sünbül²,

Kanar³

et al. 2015

BLL

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BACKGROUND: Obstructive sleep apnea (OSA) is characterized by reductions in breathing amplitude during sleep caused by an obstructed or collapsed upper airway. The neutrophil to lymphocyte ratio (NLR) has been proposed as a novel biomarker for systemic infl ammatory response. The aim of the present study was to evaluate the relationship between NLR and OSA. METHODS: The study population consisted of 195 consecutive patients with clinical suspicion of OSA. Full night polysomnography was performed for all patients. Patients with an apnea hypopnea index (AHI) ≥ 5 were considered to have OSA. NLR was calculated as the ratio of neutrophil count to lymphocyte count. RESULTS: While 130 patients (91 male, mean age: 49.9±9.8 years) had OSA, 65 patients (42 male, mean age: 48.7 ± 10.2 years) had normal fi ndings according to AHI scores. Cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking were more common in patients with OSA. Patients with OSA had signifi cantly higher NLR than controls (1.87±0.80 vs 1.49±0.48, p=0.005). AHI score was signifi cantly correlated with NLR (r=0.228, p=0.001). NLR and presence of hyperlipidemia were independent predictors of OSA (OR: 2.451, 2.850, p=0.001, 0.004, respectively). NLR of 1.62 or higher predicted OSA with a sensitivity of 56.2 % and specifi city of 63.1 %. CONCLUSIONS: NLR was higher and also correlated with AHI score in patients with OSA which has not been reported previously. NLR more than 1.62 was an independent predictor of OSA. A simple, cheap white blood cell count may also give an idea about the presence and severity of OSA (Tab. 3, Fig. 3, Ref. 30). Text in PDF www.elis.sk. KEY WORDS: infl ammation, cardiovascular risk, neutrophil to lymphocyte ratio, obstructive sleep apnea.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

Sünbül¹,

Sünbül²,

Kanar³

et al. 2015

BLL

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“…These studies demonstrated that NLR is associated with other inflammatory markers such as TNF-alpha and CRP along with lower hemoglobin, albumin and total cholesterol. 5,6,22 Lower total cholesterol and albumin are likely to reflect a combination of nutritional status and chronic inflammation in hemodialysis patients. The associations between NLR and CRP as well as lower hemoglobin, albumin and cholesterol in the present study are in keeping with published literature.…”

Section: Discussionmentioning

confidence: 99%

“…1 Recent studies have demonstrated an association between the neutrophil-lymphocyte ratio (NLR) and pro-inflammatory cytokines including TNF-alpha and IL-6 levels in pre-dialysis and dialysis patients. 5,6 Unlike TNF-alpha and IL-6, which require separate tests, NLR can be readily calculated from a patient's full blood count without incurring additional cost. NLR has been identified as a marker of systemic inflammation and prognostic marker for mortality in patients with solid organ malignancies, 7 peripheral vascular disease, 8,9 and in the setting of acute coronary syndrome.…”

Section: Introductionmentioning

confidence: 99%

Neutrophil–lymphocyte ratio predicts cardiovascular and all-cause mortality in hemodialysis patients

et al. 2015

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Neutrophil-lymphocyte ratio (NLR) is a marker of systemic inflammation that has been shown to predict mortality in patients with malignancies, ischemic heart disease and peripheral vascular disease. Its prognostic value in hemodialysis patients is unclear. The aims of this study were to: (i) explore the relationship between NLR and other biochemical parameters and (ii) to examine the value of NLR as a predictor of cardiovascular and all-cause mortality in hemodialysis patients. The study included all the incident hemodialysis patients from a single center between 2007 and 2012. NLR was calculated using samples obtained 3 months after commencing hemodialysis. One hundred seventy hemodialysis patients were included with a median follow-up of 37 months. There were 54 deaths (32%). NLR was positively correlated with C-reactive protein (r ¼ 0.24, p ¼ 0.0023) and negatively correlated with hemoglobin (r ¼ À0.27, p ¼ 0.00048), albumin (r ¼ À0.23, p ¼ 0.0034) and total cholesterol (r ¼ À0.17, p ¼ 0.049) levels. In multivariate Cox regression, NLR was independently associated with both all-cause mortality (adjusted hazard ratio [HR] 1.4; 95% confidence interval [CI], 1.2-1.6; p 0.0001) and cardiovascular death (HR 1.3, 95% CI 1.1-1.6, p ¼ 0.0032). Other predictors of all-cause mortality were age (HR 1.6 per decade; 95% CI, 1.2-2.1; p ¼ 0.0017), body mass index (HR 0.93; 95% CI, 0.88-0.98; p ¼ 0.0047), albumin (HR 0.91; 95% CI, 0.86-0.97; p ¼ 0.0035) and peripheral vascular disease (HR 2.7; 95% CI, 1.4-5.1; p ¼ 0.0023). NLR is a practical, cost-efficient and easy to use predictor of cardiovascular and all-cause mortality in incident hemodialysis patients.

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“…13 It causes not only cardiovascular disease, but also numerous chronic diseases such as cancers, diabetes mellitus, hypertension, connective tissue disease, and chronic kidney disease. [14][15][16][17][18] Figure 1: Receiver operating characteristic analysis for neutrophil-to-lymphocyte ratio to predict abnormal coronary angiography (area under curve is 0.726).…”

Section: Discussionmentioning

confidence: 99%

Association between neutrophil to lymphocyte ratio and severity of coronary artery disease

Jagadish

Manjunath

et al. 2018

Int J Adv Med

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Background: Atherosclerosis is a chronic systemic inflammatory disease. Neutrophil-to-lymphocyte ratio (NLR) is systemic inflammatory marker that is correlated with poor cardiovascular outcome. The aim of this study was to investigate the association between neutrophil to lymphocyte ratio (NLR) and severity of coronary atherosclerosis.Methods: A total of 324 patients undergoing coronary angiography were included in the study. All the patients were included in study were divided into two groups based on the result of coronary angiography report. While 226 patients had abnormal coronary angiography (case) (78 female, mean age: 60.6±12.6 years), 98 patients had normal coronary angiography (control) (60 female, mean age: 57.2±10.9 years). NLR was calculated as the ratio of neutrophil count to lymphocyte count.Results: Although age distribution was similar between the two groups(p = 0.073), female gender was significantly higher in the normal coronary angiography group (p < 0.001). Smoking history has shown a significant higher in cases compared to the normal coronary angiography (p=0.001). Patients with abnormal coronary angiography had significantly higher NLR when compared to patients with normal coronary angiography (p<0.001). NLR was significantly correlated with Gensini score. In logistic regression analyses, NLR was an independent predictor of CAD. An NLR of 2.34 or higher predicted the CAD with a sensitivity of 66% and specificity of 70%.Conclusions: There is significant association between severity of coronary artery disease and neutrophils to lymphocyte ratio. This study suggests that the NLR is an independent predictor of coronary heart disease that may be useful for cardiac risk stratification in patients with coronary artery disease.

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Neutrophil to Lymphocyte Ratio in Evaluation of Inflammation in Patients with Chronic Kidney Disease

Cited by 170 publications

References 27 publications

The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

Neutrophil–lymphocyte ratio predicts cardiovascular and all-cause mortality in hemodialysis patients

Association between neutrophil to lymphocyte ratio and severity of coronary artery disease

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