The prognostic value of platelet-to-lymphocyte ratio on the long-term renal survival in patients with IgA nephropathy
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NEPHROLOGY - ORIGINAL PAPER
The prognostic value of platelet‑to‑lymphocyte ratio on the long‑term renal survival in patients with IgA nephropathy Dan Chang1,2 · Yichun Cheng2 · Ran Luo2 · Chunxiu Zhang2 · Meiying Zuo2 · Yulin Xu2 · Wei Dai2 · Yueqiang Li2 · Min Han2 · Xiaofeng He2 · Shuwang Ge2 · Gang Xu2 Received: 10 April 2020 / Accepted: 14 September 2020 © The Author(s) 2020
Abstract Purpose Platelet-to-lymphocyte ratio (PLR) was established showing the poor prognosis in several diseases, such as malignancies and cardiovascular diseases. But limited study has been conducted about the prognostic value of PLR on the longterm renal survival of patients with Immunoglobulin A nephropathy (IgAN). Methods We performed an observational cohort study enrolling patients with biopsy-proven IgAN recorded from November 2011 to March 2016. The definition of composite endpoint was eGFR decrease by 50%, eGFR 137 group was significantly more likely to poor renal outcomes than the other two groups. Using univariate and multivariate cox regression analyses, we found that PLR > 137 was an independent prognostic factor for poor renal survival in patients with IgAN. Subgroup analysis revealed that the PLR remained the prognostic value for female patients or patients with eGFR less than 60 mL/min/1.73 m2. Conclusions Our results underscored that baseline PLR was an independent prognostic factor for poor renal survival in patients with IgAN, especially for female patients or those patients with baseline eGFR less than 60 mL/min/1.73 m2. Keywords Immunoglobulin A nephropathy · Platelet-to-lymphocyte ratio · Renal survival · Cohort Abbreviations PLR Platelet-to-lymphocyte ratio IgAN Immunoglobulin A nephropathy ESRD End-stage renal disease Dan Chang and Yichun Cheng contributed equally to this work. * Shuwang Ge [email protected] * Gang Xu [email protected] 1
Department of Nephrology, University of Electronic Science and Technology, Sichuan Academy of Sciences and Sichuan Provincial People’s Hospital, Chengdu, Sichuan, China
Department of Nephrology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
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SBP Systolic blood pressure DBP Diastolic blood pressure MAP Mean arterial pressure WBC White blood cell count Scr Serum creatinine UA Uric acid eGFR Estimated glomerular filtration rate MDRD Modification of Diet in Renal Disease Study SD Standard deviation IQR Interquartile range HRs Hazard ratios CIs Confidence intervals RAAS Rein-angiotensin-aldosterone-system IS Immune suppression
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International Urology and Nephrology
Introduction
Materials and methods
Immunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulonephritis worldwide [1]. The number of patients with IgAN accounts for 58.2% of glomerulonephritis in China [2]. Studies have shown that 15% to 40% of patients with IgAN develop the end-stage renal disease (ESRD) by 10 to 20 years after diagnosis [3, 4]. As one of the mai
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