Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in evaluation of inflammation in non-dialysis patients w
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RESEARCH ARTICLE
Open Access
Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in evaluation of inflammation in non-dialysis patients with end-stage renal disease (ESRD) Peiyuan Li1, Chenqi Xia2, Peng Liu2, Zhong Peng1, Hong Huang3, Juan Wu1 and Zhangxiu He2*
Abstract Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been reported to be associated with inflammation in end-stage renal disease (ESRD) receiving dialysis. However, the value of NLR and PLR in non-dialysis patients with ESRD remains unclear. Methods: Among 611 non-dialysis patients with ESRD in The First Affiliated Hospital of University of South China (2012–2018), we compared NLR and PLR in patients with high-sensitivity C-reactive protein (hs-CRP) levels of ≤3 mg/L vs. > 3 mg/L. Correlation of NLR and PLR to hs-CRP, PCT, ferritin were analyzed. Receiver operating characteristics (ROC) analysis was used for estimating sensitivity and specificity of NLR and PLR. Results: NLR was higher in the patients with high hs-CRP levels (> 3 mg/L), compared to patients with low hs-CRP levels (≤ 3 mg/L) [5.74 (3.54–9.01) vs. 3.96 (2.86–5.85), p < 0.0001]. Additionally, PLR was higher in high hs-CRP group than in low group [175.28 (116.67–252.26) vs. 140.65 (110.51–235.17), p = 0.022]. In the current study, NLR and PLR were both positively correlated with hs-CRP (rs = 0.377, p = 0.000 for NLR; rs = 0.161, p = 0.001 for PLR), PCT, leukocytes, neutrophils, platelets, and age. NLR or PLR with a cut-off value of 5.07 or 163.80 indicated sensitivity and specificity were 65.67 and 66.37% (AUC = 0.69) or 57.21 and 57.52% (AUC = 0.55), respectively. Conclusions: NLR or PLR was positively correlated with hs-CRP in non-dialysis patients with ESRD. NLR might be better for identifying inflammation than PLR in this population. Keywords: Neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), Inflammation, Non-dialysis patients with end-stage renal disease (ESRD)
Background Inflammation is involved in the process of end-stage renal disease (ESRD) mainly caused by diabetic nephropathy and chronic glomerulonephritis [1–3]. Our previous study and others showed that inflammatory marker is a significant predictor of intima-media thickness (IMT) * Correspondence: [email protected] 2 Department of Nephrology, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province 421001, PR China Full list of author information is available at the end of the article
progression and increased IMT had poor survival in ESRD patients [4–6]. It has been reported that increased IMT, as a strong predictor of cardiovascular disease and mortality, was associated with inflammation even in non-dialysis patients [5, 7]. Thus, it is important to pay attention to inflammation in ESRD as well as nondialysis patients. Inflammatory markers such as C-reactive protein (CRP), procalcitonin (PCT), and ferritin are widely used in ESRD [8–10]. However, those traditional biomarkers
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