P0302neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio in Patients Undergoing Kidney Transplant

Abstract

Background and Aims Inflammation plays a central role before and after a kidney transplant recipients (KTR). Despite survival improvement, several factors are associated with poor outcomes after transplantation. In search of a cost effective inflammatory marker neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) have shown a prognostic value. Therefore, the objective of this study was to determine the association of NLR and PLR and acute kidney allograft dysfunction as markers of inflammatory state in KTR. Method A single center, retrospective study. Our study group included 41 KTR with acute kidney allograft dysfunction from our center at Centro Medico Nacional de Occidente, Jalisco, Mexico. NLR and PLR were collected and evaluated 1 month prior KT, at the time, 6 months and one year after transplantation. Statistical analysis: Data were expressed as the mean ± SD, median and range or frequency, as appropriate. Intergroup comparisons were performed with a chi-squared test for categorical variables and Student’s t test or the Mann-Whitney test for continuous variables. Putative associations between clinical factors, biological factors and mortality were assessed in univariate and multivariate Cox models. Statistical analyses were performed using SPSS v26.0 (IBM Corporation, NY, USA); p < 0.05 was considered statistically significant. Results Mean age was 29.54 ± 7.32 years, and 56% were women. Of those patients, all received living donor kidney transplantation. All patients in the study groups received standardized immunosuppressive regimen consisting of calcineurin inhibitors, mycophenolate mofetil and steroids. Median serum creatinine levels after KT were between 1.11 ± 0.36 mg/dl. The median NLR and PLR levels were significantly higher in the study group, with a median of 3.34 (1.83 –5.14) and 8.65 (343.47 – 360.59), not statistically associated. The best set of predictors in multiple regression analysis of higher levels of NLR were serum albumin (r = -0.432; p = 0.007) and C reactive protein (r = 0.641; p = 0.002). The best set of predictors in multiple regression analysis of higher levels of PLR were hematocrit (r = -0.313; p = 0.055) and serum glucose (r = 0.360; p = 0.026). Conclusion Our data showed that higher values of NLR and PLR are associated with inflammatory markers, leading to the conclusion that this finding must be confirmed with larger, prospective and controlled follow up.