The prognostic value of platelet-to-lymphocyte ratio on the long-term renal survival in patients with IgA nephropathy

Abstract

Purpose Platelet-to-lymphocyte ratio (PLR) was established showing the poor prognosis in several diseases, such as malignancies and cardiovascular diseases. But limited study has been conducted about the prognostic value of PLR on the long-term renal survival of patients with Immunoglobulin A nephropathy (IgAN). Methods We performed an observational cohort study enrolling patients with biopsy-proven IgAN recorded from November 2011 to March 2016. The definition of composite endpoint was eGFR decrease by 50%, eGFR < 15 mL/min/1.73 m2, initiation of dialysis, or renal transplantation. Patients were categorized by the magnitude of PLR tertiles into three groups. The Kaplan–Meier curves and multivariate Cox models were performed to determine the association of PLR with the renal survival of IgAN patients. Results 330 patients with a median age of 34.0 years were followed for a median of 47.4 months, and 27 patients (8.2%) had reached the composite endpoints. There were no differences among the three groups (PLR < 106, 106 ≤ PLR ≤ 137, and PLR > 137) in demographic characteristics, mean arterial pressure (MAP), proteinuria, and estimated glomerular filtration rate (eGFR) at baseline. The Kaplan–Meier curves showed that the PLR > 137 group was significantly more likely to poor renal outcomes than the other two groups. Using univariate and multivariate cox regression analyses, we found that PLR > 137 was an independent prognostic factor for poor renal survival in patients with IgAN. Subgroup analysis revealed that the PLR remained the prognostic value for female patients or patients with eGFR less than 60 mL/min/1.73 m2. Conclusions Our results underscored that baseline PLR was an independent prognostic factor for poor renal survival in patients with IgAN, especially for female patients or those patients with baseline eGFR less than 60 mL/min/1.73 m2.

Sexual Effect of Platelet-to-Lymphocyte Ratio in Predicting Cardiovascular Mortality of Peritoneal Dialysis Patients

“…PLR may be more valuable than counting platelets or lymphocytes alone due to its reflection of both inflammation and thrombosis [ 22 ]. Some studies have reported the association of PLT and mortality.…”

“…However, another research from Central China reported that there was no difference between male and female in PLR [ 33 ]. A study showed that high baseline PLR could predict poor renal survival in patients with IgAN, especially in female cases [ 22 ]. In our study, we found that the sex difference in PLR may influence the effects of PLR on mortality in PD patients.…”

Correlation of Different Serum Biomarkers with Prediction of Early Pancreatic Graft Dysfunction Following Simultaneous Pancreas and Kidney Transplantation

“…Our current findings are consistent with previous studies in the non-transplant setting, showing weak or acceptable predictive values of PLR and/or NLR for prediction of postoperative pancreas-related complications following pancreatic surgery as well as a reduced ability for the prediction of the severity of the disease in acute pancreatitis [9,14,16,37,43,46]. However, after liver and kidney transplantation alone, preoperative NLR and PLR levels as well as their distinct postoperative course could be identified as independent predictors of early graft dysfunction and decreased graft survival in the long-term follow up [47][48][49][50].…”

Clinical and Histopathological Factors Influencing IgA Nephropathy Outcome

“…Platelet-to-lymphocyte ratio (PLR) calculated as platelet count divided by lymphocyte count has been established as a novel marker of malignancies, cardiovascular diseases, and chronic obstructive pulmonary disease [21][22][23]. In Kaplan-Meier analysis, PLR more than 137 was found to be a predictive factor of poor renal outcome ESRD [24]. Both NLR and PLR were assessed as markers of inflammatory states, and their prognostic significance has been established in several conditions such as rheumatoid arthritis, solid tumors, and coronary artery disease.…”