Yilmaz Gulay, Sevinc Can, Ustundag Sedat, Yavuz Yasemin Coskun, Hacıbekiroglu Tuba, Hatipoglu Esra, Baysal Mehmet
Department of Nephrology, Faculty of Medicine, Fatih University, Istanbul, Turkey.
Department of Nephrology, Erzurum Regional Research and Training Hospital, Erzurum, Turkey.
Saudi J Kidney Dis Transpl. 2017 Jan-Feb;28(1):90-94. doi: 10.4103/1319-2442.198152.
Atherosclerosis, which develops as a result of inflammation, is the most important cause of morbidity and mortality in chronic kidney disease (CKD). In this study, we investigated the relationship of mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) with inflammation and proteinuria in patients with CKD Stage 3-4. Healthy individuals who applied to nephrology clinic for checkup purposes acted as controls. Fifty-three patients and 30 healthy controls were included in the study. Patients with diabetes mellitus, active infection, malignancy, and coronary artery disease were excluded from the study. Biochemistry values and hemograms were recorded for all patients and for control group. NLR was calculated. The relationship between MPV/NLR and protein, fibrinogen, and proteinuria was evaluated. Our study showed a statistically significant difference between CKD group and healthy control (HC) group in uric acid, fibrinogen, C-reactive protein, and NLR values (P <0.01, P <0.01, P = 0.01, P <0.01, respectively). No statistically significant difference was found between CKD and HC groups for MPV (P = 0.307). Correlation analysis revealed a statistically significant relationship between NLR and creatinine (P <0.00, r = 0.571), uric acid (P <0.00, r = 0.436), glomerular filtration rate (P <0.00, r = -0.418), 24 h urine protein (P = 0.004, r = 0.311), and 24 h urine microalbumin (P = 0.001, r = 0.354). A statistically significant relationship was detected between MPV and platelet count (P <0.001, r = -0.422), age (P = 0.004, r = -0.312), uric acid (P = 0.04, r = -0.226), and fibrinogen (P = 0.023, r = -0.249). Whereas, a statistically significant relationship was detected between NLR and microalbuminuria/proteinuria, there was no statistically significant relationship between MPV and microalbuminuria/proteinuria. Our study showed that the NLR is high in CKD group and is correlated with uric acid and proteinuria, which are known to be associated with atherosclerosis, in patients with CKD. NLR may be a determinant of inflammation and atherosclerosis in patients with CKD.
动脉粥样硬化是慢性肾脏病（CKD）发病和死亡的最重要原因，其由炎症引发。在本研究中，我们调查了3-4期CKD患者的平均血小板体积（MPV）和中性粒细胞/淋巴细胞比值（NLR）与炎症及蛋白尿之间的关系。以因体检目的前往肾病科门诊的健康个体作为对照。本研究纳入了53例患者和30例健康对照。排除患有糖尿病、活动性感染、恶性肿瘤和冠状动脉疾病的患者。记录了所有患者及对照组的生化指标和血常规结果。计算了NLR。评估了MPV/NLR与蛋白、纤维蛋白原及蛋白尿之间的关系。我们的研究显示，CKD组与健康对照（HC）组在尿酸、纤维蛋白原、C反应蛋白及NLR值方面存在统计学显著差异（分别为P<0.01、P<0.01、P = 0.01、P<0.01）。CKD组与HC组的MPV无统计学显著差异（P = 0.307）。相关性分析显示，NLR与肌酐（P<0.00，r = 0.571）、尿酸（P<0.00，r = 0.436）、肾小球滤过率（P<0.00，r = -0.418）、24小时尿蛋白（P = 0.004，r = 0.311）及24小时尿微量白蛋白（P = 0.001，r = 0.354）之间存在统计学显著关系。检测到MPV与血小板计数（P<0.001，r = -0.422）、年龄（P = 0.004，r = -0.312）、尿酸（P = 0.04，r = -0.226）及纤维蛋白原（P = 0.023，r = -0.249）之间存在统计学显著关系。虽然检测到NLR与微量白蛋白尿/蛋白尿之间存在统计学显著关系，但MPV与微量白蛋白尿/蛋白尿之间无统计学显著关系。我们的研究表明，CKD组的NLR较高，且与CKD患者中已知与动脉粥样硬化相关的尿酸及蛋白尿相关。NLR可能是CKD患者炎症和动脉粥样硬化的一个决定因素。
