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