Effects of neutrophil–lymphocyte ratio on renal function and histologic lesions in patients with diabetic nephropathy. Issue 11 (29th April 2019)

• Record Type: Journal Article
• Authors: Zhang, Junlin; Zhang, Rui; Wang, Yiting; Wu, Yucheng; Li, Hanyu; Han, Qianqian; Guo, Ruikun; Wang, Tingli; Wang, Jiali; Grung, Pramesh; Liu, Fang
• Is Part Of: Nephrology. Volume 24:Issue 11(2019)
• Page Start: 1115
• Page End: 1121
• Publication Date: 2019-04-29
• Subjects: diabetic nephropathy -- histologic lesion -- neutrophil–lymphocyte ratio -- renal function -- type 2 diabetes mellitus; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.13517
• Languages: English
• ISSNs: 1320-5358

Abstract

ABSTRACT: Aim: Chronic low‐grade inflammation related to diabetic nephropathy (DN) may affect the serum neutrophil–lymphocyte ratio (NLR). We aimed to examine the cross‐sectional relationships of NLR with renal function and structural lesions of DN in patients with type 2 diabetes mellitus (T2DM). Methods: The study retrospectively included 247 patients with T2DM and biopsy‐proven DN. The severity of different pathological lesions was evaluated based on the criteria of Renal Pathology Society. The patients were divided into two groups based on the median (2.42) of NLR level, group 1: NLR < 2.42 ( n = 122) and group 2: NLR ≥ 2.42 ( n = 125). Renal dysfunction was defined by estimated glomerular filtration rate less than 60 mL/min per 1.73 m 2 . The influence of NLR on renal dysfunction was evaluated using logistic regression analysis. Results: The spearman's rank‐correlation test indicted that NLR was positively correlated with interstitial fibrosis and tubular atrophy (r = 0.170, P = 0.007) and serum fibrinogen (r = 0.261, P < 0.001), whereas negatively related with estimated glomerular filtration rate (r = −0.233, P < 0.001). However, the NLR level demonstrated no association with glomerular lesions, interstitial inflammation and arteriolar hyalinosis. A multivariate logistic regression analysis showed that higher level of NLR (≥2.42) was significantly associated with renal dysfunction when adjusting for some important baseline clinical and pathological variables (odds ratio, 2.46; 95% confidence interval, 1.21–4.97; P = 0.012). Conclusion: Increased NLR affects renal function and histologic lesions in patients with T2DM and may be an important factor for the progression of DN. SUMMARY AT A GLANCE: Neutrophil/lymphocyte ratio may be a novel inflammatory biomarker that is useful in identifying type 2 diabetics with more severe renal disease. In this cohort study of 247 patients with type 2 diabetes and diabetic nephropathy, higher neutrophil/lymphocyte ratio is associated with more advanced diabetic nephropathy and inversely associated with renal function. However, this finding will need to be validated in other cohort.