Pineault Jérôme, Lamarche Caroline, Bell Robert, Lafrance Jean-Philippe, Ouellet Georges, Leblanc Martine, Pichette Vincent, Bezzaoucha Sarah, Vallée Michel
Department of Medicine, Division of Nephrology, Hôpital Maisonneuve-Rosemont, Montreal, Québec, Canada.
Department of Medicine, Université de Montréal, Québec, Canada.
Can J Kidney Health Dis. 2017 Nov 3;4:2054358117735563. doi: 10.1177/2054358117735563. eCollection 2017.
Neutrophil-to-lymphocyte ratio (NLR) was widely studied as a prognostic marker in various medical and surgical specialties, but its significance in nephrology is not yet established.
We evaluated its accuracy as an inflammation biomarker in a dialysis population.
Single-center retrospective study.
The records of all 550 patients who were treated with hemodialysis (HD) or peritoneal dialysis (PD) from September 2008 to March 2011 were included.
NLR was calculated from the monthly complete blood count.
Association between NLR and markers of inflammation (C-reactive protein [CRP], serum albumin, and erythropoietin resistance index [ERI]) was measured using Spearman coefficient.
In total, 120 patients were eligible for the correlation analyses. We found a positive correlation between NLR and CRP (all patients: = 0.45, < .001; HD: = 0.47, < .001; PD: = 0.48, = .13). NLR and albumin were inversely correlated ( = -0.51, < .001). Finally, high NLR was associated with a nonsignificant increased ERI, but we have not demonstrated a direct correlation.
CRP and albumin are not measured routinely and were ordered for a specific clinical reason leading to an indication bias. Also, no relationship with clinical outcome was established.
NLR seems to be a good inflammatory biomarker in dialysis in addition to being easily available. However, controlled studies should be conducted to properly assess and validate NLR levels that would be clinically significant and relevant, as well as its prognostic significance and utility in a clinical setting.
中性粒细胞与淋巴细胞比值（NLR）作为一种预后标志物在各种医学和外科专业中得到了广泛研究，但其在肾脏病学中的意义尚未确立。
我们评估了其作为透析人群炎症生物标志物的准确性。
单中心回顾性研究。
纳入了2008年9月至2011年3月期间接受血液透析（HD）或腹膜透析（PD）治疗的所有550例患者的记录。
根据每月的全血细胞计数计算NLR。
使用Spearman系数测量NLR与炎症标志物（C反应蛋白[CRP]、血清白蛋白和促红细胞生成素抵抗指数[ERI]）之间的关联。
共有120例患者符合相关性分析条件。我们发现NLR与CRP之间呈正相关（所有患者：r = 0.45，P <.001；HD：r = 0.47，P <.001；PD：r = 0.48，P =.13）。NLR与白蛋白呈负相关（r = -0.51，P <.001）。最后，高NLR与ERI的非显著性升高相关，但我们尚未证明存在直接相关性。
CRP和白蛋白并非常规测量，而是因特定临床原因进行检测，导致存在指示偏倚。此外，未建立与临床结局的关系。
NLR除了易于获取外，似乎还是透析中一种良好的炎症生物标志物。然而，应进行对照研究，以正确评估和验证具有临床意义和相关性的NLR水平，以及其在临床环境中的预后意义和实用性。
