Neutrophil-to-lymphocyte Ratio as a Predictor of Renal Dysfunction in Diabetes Patients

Researchers have found that Neutrophil-to-lymphocyte ratio is a predictor of renal dysfunction in diabetes patients. The study has been published in Diabetes Metabolic Syndrome: Clinical Research & Reviews.

Inflammation plays an important role in the pathogenesis of diabetic kidney disease. Neutrophil-to-lymphocyte ratio has been evaluated as a biomarker of inflammation and has been widely evaluated as a biomarker in various medical and surgical prognoses. However, its usefulness in diabetic kidney disease is not yet known.

The researchers conducted a prospective observational study that included outpatients, comprising of 184 men aged 73 ± 11 (mean ± standard deviation) years and 174 women aged 76 ± 10 years at baseline, from a rural hospital. They examined the relationship between baseline NLR calculated by analyzing the differential leukocyte counts in the complete blood count and the 2-year estimated glomerular filtration rate (eGFR) decline rate (i.e., 2-year eGFR-baseline eGFR) ∗100/baseline eGFR. Rapid eGFR decline rate was defined as a value < -25%.

The researchers found that NLR (β = 0.138, p = 0.007) as well as the presence of antidyslipidemic medication, hemoglobin A1c, and urinary albumin excretion stage were significantly and independently associated with a rapid eGFR decline rate. The multiple linear regression analysis using rapid eGFR decline rates as objective variables were adjusted for confounding factors as explanatory variables.

The multivariate-adjusted odds ratios (95% confidence interval) of the 2nd and 3rd tertiles of baseline NLR for rapid eGFR decline rate were 3.62 (0.70-18.7) and 8.03 (1.54-41.9), respectively. Multivariate-adjusted mean eGFR (95% confidence interval) values after 2 years categorized by tertile of baseline NLR were:

• 1st: 63.9 (61.8-66.1)
• 2nd: 60.8 (58.7-62.9)
• 3rd: 58.9 (56.8-61.0)

The researchers concluded that these results suggest that baseline Neutrophil-to-lymphocyte ratio might be a useful biomarker for renal function decline in outpatients with type 2 diabetes. This biomarker may help evaluate renal function in diabetics.

For further reference, log on to: https://doi.org/10.1016/j.dsx.2020.04.029