Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, China.
J Transl Med. 2019 Mar 15;17(1):86. doi: 10.1186/s12967-019-1808-4.
Chronic kidney disease (CKD) leads to end-stage renal failure and cardiovascular events. An attribute to these progressions is abnormalities in inflammation, which can be evaluated using the neutrophil-to-lymphocyte ratio (NLR). We aimed to investigate the association of NLR with the progression of end stage of renal disease (ESRD), cardiovascular disease (CVD) and all-cause mortality in Chinese patients with stages 1-4 CKD.
Patients with stages 1-4 CKD (18-74 years of age) were recruited at 39 centers in 28 cities across 22 provinces in China since 2011. A total of 938 patients with complete NLR and other relevant clinical variables were included in the current analysis. Cox regression analysis was used to estimate the association between NLR and the outcomes including ESRD, CVD events or all-cause mortality.
Baseline NLR was related to age, hypertension, serum triglycerides, total serum cholesterol, CVD history, urine albumin to creatinine ratio (ACR), chronic kidney disease-mineral and bone disorder (CKD-MBD), hyperlipidemia rate, diabetes, and estimated glomerular filtration rate (eGFR). The study duration was 4.55 years (IQR 3.52-5.28). Cox regression analysis revealed an association of NLR and the risk of ESRD only in patients with stage 4 CKD. We did not observe any significant associations between abnormal NLR and the risk of either CVD or all-cause mortality in CKD patients in general and CKD patients grouped according to the disease stages in particular.
Our results suggest that NLR is associated with the risk of ESRD in Chinese patients with stage 4 CKD. NLR can be used in risk assessment for ESRD among patients with advanced CKD; this application is appealing considering NLR being a routine test. Trial registration ClinicalTrials.gov Identifier NCT03041987. Registered January 1, 2012. (retrospectively registered) ( https://www.clinicaltrials.gov/ct2/show/NCT03041987?term=Chinese+Cohort+Study+of+Chronic+Kidney+Disease+%28C-STRIDE%29&rank=1 ).
慢性肾脏病（CKD）可导致终末期肾衰竭和心血管事件。炎症异常是这些进展的一个因素，可以使用中性粒细胞与淋巴细胞比值（NLR）来评估。我们旨在研究 NLR 与中国 1-4 期 CKD 患者终末期肾脏疾病（ESRD）、心血管疾病（CVD）和全因死亡率进展的相关性。
自 2011 年以来，在中国 22 个省的 28 个城市的 39 个中心招募了 1-4 期 CKD（18-74 岁）患者。共有 938 名患者完成了 NLR 和其他相关临床变量的检测，纳入本分析。Cox 回归分析用于估计 NLR 与包括 ESRD、CVD 事件或全因死亡率在内的结局之间的关系。
基线 NLR 与年龄、高血压、血清甘油三酯、总胆固醇、CVD 病史、尿白蛋白与肌酐比值（ACR）、慢性肾脏病矿物质和骨异常（CKD-MBD）、高血脂率、糖尿病和估算肾小球滤过率（eGFR）相关。研究持续时间为 4.55 年（IQR 3.52-5.28）。Cox 回归分析显示，仅在 4 期 CKD 患者中，NLR 与 ESRD 风险相关。我们没有观察到异常 NLR 与 CKD 患者 CVD 或全因死亡率风险之间的任何显著关联，无论是在一般 CKD 患者中还是在按疾病阶段分组的 CKD 患者中。
我们的研究结果表明，NLR 与中国 4 期 CKD 患者的 ESRD 风险相关。NLR 可用于评估晚期 CKD 患者的 ESRD 风险；考虑到 NLR 是常规检测，这种应用具有吸引力。
ClinicalTrials.gov 标识符 NCT03041987。于 2012 年 1 月 1 日注册（回顾性注册）（https://www.clinicaltrials.gov/ct2/show/NCT03041987？term=Chinese+Cohort+Study+of+Chronic+Kidney+Disease+%28C-STRIDE%29&rank=1）。
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