中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值对快速进展性肾小球肾炎患者肾脏预后的预测价值

Prognostic Value of Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio for Renal Outcomes in Patients with Rapidly Progressive Glomerulonephritis.

作者信息

Mae Yukari, Takata Tomoaki, Ida Ayami, Ogawa Masaya, Taniguchi Sosuke, Yamamoto Marie, Iyama Takuji, Fukuda Satoko, Isomoto Hajime

机构信息

Division of Medicine and Clinical Science, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8504, Japan.

出版信息

J Clin Med. 2020 Apr 15;9(4):1128. doi: 10.3390/jcm9041128.

BACKGROUND

Rapidly progressive glomerulonephritis (RPGN) is a syndrome characterized by a rapid decline in renal function that often causes end-stage renal disease. Although it is important to predict renal outcome in RPGN before initiating immunosuppressive therapies, no simple prognostic indicator has been reported. The aim of this study was to investigate the associations of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to renal outcomes in patients with RPGN.

METHODS

Forty-four patients with a clinical diagnosis of RPGN who underwent renal biopsy were enrolled. The relationships between NLR and PLR and renal outcome after 1 year were investigated.

RESULTS

NLR and PLR were significantly higher in patients with preserved renal function in comparison to patients who required maintenance hemodialysis ( < 0.05 and < 0.01, respectively). An NLR of 4.0 and a PLR of 137.7 were the cutoff values for renal outcome (area under the curve, 0.782 and 0.819; sensitivity, 78.4% and 89.2%; specificity, 71.4% and 71.4%, respectively). Furthermore, an NLR of 5.0 could predict recovery from renal injury in patients requiring hemodialysis (area under the curve, 0.929; sensitivity, 83.3%; specificity, 85.7%).

CONCLUSION

NLR and PLR could be candidates for predicting renal outcomes in patients with RPGN.

背景

快速进展性肾小球肾炎（RPGN）是一种以肾功能迅速下降为特征的综合征，常导致终末期肾病。尽管在开始免疫抑制治疗前预测RPGN的肾脏预后很重要，但尚未有简单的预后指标报道。本研究的目的是探讨中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）与RPGN患者肾脏预后的相关性。

方法

纳入44例临床诊断为RPGN并接受肾活检的患者。研究了NLR和PLR与1年后肾脏预后的关系。

结果

与需要维持性血液透析的患者相比，肾功能保留的患者NLR和PLR显著更高（分别<0.05和<0.01）。NLR为4.0和PLR为137.7是肾脏预后的临界值（曲线下面积分别为0.782和0.819；敏感性分别为78.4%和89.2%；特异性分别为71.4%和71.4%）。此外，NLR为5.0可预测需要血液透析的患者肾损伤的恢复情况（曲线下面积为0.929；敏感性为83.3%；特异性为85.7%）。