Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as a risk factor for mortality in peruvian adults with chronic kidney disease.
Gianfranco Eddú Umeres-Francia1, María Valentina Rojas-Fernández1, Percy Herrera-Añazco1, Vicente Aleixandre Benites-Zapata2
1 Universidad Peruana de Ciencias Aplicadas, School of Medicine, Lima, Peru
2 Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
Corresponding author:
Vicente A. Benites-Zapata
vbeniteszapata@gmail.com
Avenida La Fontana 750, La Molina, Lima, Peru;
51 995 523 081
Disclosure statement: None to declare.
Authors’ contributions: GEUF, MVRF, PHA and VABZ have participated in the conception of the article, the data collection, its writing and approval of the final version. In addition, VABZ performed the data analysis.
Funding sources: This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Abstract.
Objective: To assess the association between NLR and PLR with all-cause mortality in Peruvian patients with CKD
Methods: We conducted a retrospective cohort study in adults with CKD in stages 1 to 5. The outcome variable was mortality and as variables of exposure to NLR and PLR. Both ratios were categorized as high with a cut-off point of 3.5 and 232.5; respectively. We carried out a Cox regression model and calculated crude and adjusted hazard ratios (HR) with their 95% confidence interval (95%CI).
Results: We analyzed 343 participants with a median follow-up time of 2.45 years (2.08-3.08). The frequency of deaths was 17.5% (n=60). In the crude analysis, the high NLR and PLR were significantly associated with all-cause mortality (HR=2.01; 95% CI:1.11-3.66) and (HR=2.58; 95% CI:1.31-5.20). In the multivariate model, after adjusting for age, sex, serum creatinine, CKD stage, albumin and hemoglobin, the high NLR and PLR remained as an independent risk factor for all-cause mortality, (HR=2.10; 95% CI:1.11-3.95) and (HR=2.71; 95% CI:1.28-5.72).
Conclusion: Our study suggests the relationship between high NLR and PLR with all-cause mortality in patients with CKD.
Keywords: Kidney Failure, Chronic; Neutrophils; Blood Platelets; Lymphocytes; Mortality