Neutrophil-to-Lymphocyte and Platelet-to-lymphocyte Ratios as a Predictor Factors for Chronic Kidney Disease Progression
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: CKD. Basic parameters: 18 years — 65 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
In this study, we aim to investigate whether NLR and PLR levels are associated with decline of kidney function in patients with CKD.
Detailed description
Chronic inflammation is closely associated with various chronic diseases, such as diabetes mellitus, cardiovascular disease, and chronic kidney disease (CKD) (1). Patients with CKD tend to have elevated levels of inflammatory mediators, including high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF alpha), and interleukin (IL)-6 (2).These mediators stimulate inflammatory pathway, leading to glomerular hypertension, tubulointerstitial fibrosis, kidney scarring, and, finally, CKD progression and increased cardiovascular events (3,4). Therefore, it is important to evaluate and decrease the extent of chronic inflammation in patients with CKD. Patients with CKD have higher levels of proinflammatory cytokines, but it remains unclear which biomarker is the best indicator of inflammation in patients with CKD.
The neutrophil-to-lymphocyte ratio (NLR), obtained by dividing the absolute number of neutrophils to the lymphocyte count, is increasingly studied as a new inflammatory marker. An elevated NLR has recently been reported to be an independent predictor of mortality in patients with cardiovascular disease or cancer \[5-8\]. As CKD is a chronic inflammatory disease, high NLR can predict CKD progression, cardiovascular disease and cancer. However, significantly few studies have investigated the association between high NLR and CKD progression \[9-12\].
Platelet-to-lymphocyte ratio (PLR) has recently been recognized as a novel inflammatory marker and has been shown to be associated with the prognosis in CKD patients \[13\].
In 2012, Kidney Disease: Improving Global Outcome (KDIGO) classified CKD in six categories by GFR estimation (in mL/min/1.73 m2).
Primary outcome measures
- Correlation between NLR, PLR and severity of CKD. [Time frame: Baseline]
Eligibility criteria
Inclusion criteria
- 200 Patients diagnosed with CKD and their age range between 18-65 years old who will be admitted at AUH.
Exclusion criteria
- Pediatric patients aged below< 18 or elderly patients aged above 65.
- Pregnant females.
- Patients with Diabetes Mellitus.
- Acute kidney injury (AKI).
- Patients with current infections.
- Patients who have any type of malignancy.
- Patients who have any type of multi-organ failure.
- CKD patients on dialysis
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Study design
- Observational model
- Cohort
Study locations
Center list to be confirmed — check the primary protocol.
Publications
- Gan W, Guan Q, Hu X, Zeng X, Shao D, Xu L, Xiao W, Mao H, Chen W. The association between platelet-lymphocyte ratio and the risk of all-cause mortality in chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol. 2022 Nov;54(11):2959-2967. doi: 10.1007/s11255-022-03234-0. Epub 2022 May 17. PMID 35581444
- Altunoren O, Akkus G, Sezal DT, Ciftcioglu M, Guzel FB, Isiktas S, Torun GI, Uyan M, Sokmen MF, Sevim HA, Sarisik FN, Senel ME, Erken E, Gungor O. Does neutrophyl to lymphocyte ratio really predict chronic kidney disease progression? Int Urol Nephrol. 2019 Jan;51(1):129-137. doi: 10.1007/s11255-018-1994-7. Epub 2018 Oct 1. PMID 30276600
- Navarro JF, Milena FJ, Mora C, Leon C, Garcia J. Renal pro-inflammatory cytokine gene expression in diabetic nephropathy: effect of angiotensin-converting enzyme inhibition and pentoxifylline administration. Am J Nephrol. 2006;26(6):562-70. doi: 10.1159/000098004. Epub 2006 Dec 13. PMID 17167242
- Turkmen K, Guney I, Yerlikaya FH, Tonbul HZ. The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren Fail. 2012;34(2):155-9. doi: 10.3109/0886022X.2011.641514. Epub 2011 Dec 16. PMID 22172001
- Manabe I. Chronic inflammation links cardiovascular, metabolic and renal diseases. Circ J. 2011;75(12):2739-48. doi: 10.1253/circj.cj-11-1184. Epub 2011 Nov 8. PMID 22067929
Identifiers
NCT: NCT06670599 · NLR & PLR in CKD.