Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Korean J Intern Med. 2023 Sep;38(5):725-733. doi: 10.3904/kjim.2023.171. Epub 2023 Aug 17.
BACKGROUND/AIMS: The neutrophil-to-lymphocyte ratio (NLR) has a prognostic value in cardiovascular disease, infection, inflammatory disease, and several malignancies. Therefore, the NLR has a possible predictive value in patients with chronic kidney disease (CKD), but this predictive value has not been validated. Here, we aimed to investigate the possibility of NLR as a predictor of CKD progression.
This retrospective observational study included 141 patients with non-dialysis CKD. The participants were divided into terciles (T1, T2, and T3) according to NLR. The primary outcome was defined as a composite kidney event, which included a decline in the estimated glomerular filtration rate (eGFR) of at least 50% or initiation of renal replacement therapy during the follow-up period.
The mean follow-up duration was 5.45 ± 2.11 years. The mean NLRs were 1.35 ± 0.05 in T1 (n = 47), 2.16 ± 0.04 in T2 (n = 47), and 4.29 ± 0.73 in T3 (n = 47). The group with the highest NLR (T3) had higher baseline CKD and serum creatinine and lower eGFR levels than the group with the lowest NLR (T1). The cumulative incidence rate of composite kidney events was significantly higher in T3 compared with T1 (p < 0.001, log-rank test). Cox regression analysis revealed that high NLR was associated with the risk of composite kidney events (adjusted hazard ratio, 3.33; 95% confidence interval, 1.43-7.76).
A higher NLR reflects the more advanced stage of CKD and suggests a role for NLR as a biomarker for predicting CKD progression.
背景/目的：中性粒细胞与淋巴细胞比值（NLR）在心血管疾病、感染、炎症性疾病和多种恶性肿瘤中具有预后价值。因此，NLR 可能对慢性肾脏病（CKD）患者具有预测价值，但这一预测价值尚未得到验证。在这里，我们旨在研究 NLR 作为 CKD 进展预测因子的可能性。
这是一项回顾性观察性研究，纳入了 141 名非透析 CKD 患者。参与者根据 NLR 分为三分位（T1、T2 和 T3）。主要结局定义为复合肾脏事件，包括在随访期间 eGFR 至少下降 50%或开始肾脏替代治疗。
平均随访时间为 5.45±2.11 年。T1 组（n=47）、T2 组（n=47）和 T3 组（n=47）的平均 NLR 分别为 1.35±0.05、2.16±0.04 和 4.29±0.73。NLR 最高的 T3 组（n=47）的基线 CKD、血清肌酐较高，eGFR 水平较低。与 NLR 最低的 T1 组（n=47）相比，T3 组的复合肾脏事件累积发生率显著更高（p＜0.001，对数秩检验）。Cox 回归分析显示，高 NLR 与复合肾脏事件的风险相关（调整后的危险比，3.33；95%置信区间，1.43-7.76）。
较高的 NLR 反映了 CKD 更晚期的阶段，并提示 NLR 可作为预测 CKD 进展的生物标志物。
