Neutrophil-to-lymphocyte ratio as a predictor of worsening renal function in diabetic patients (3-year follow-up study)

Basem Azab, Jacques Daoud, Fahad Ben Naeem, Rabih Nasr, Jennifer Ross, Pratima Ghimire, Ayesha Siddiqui, Nadine Azzi, Nancy Rihana, Marie Abdallah, Nassif Azzi, Parishram Patel, Morton Kleiner, Suzanne El-Sayegh

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46 Citations (Scopus)

Abstract

Background: Previous studies have demonstrated the role of inflammation in diabetic nephropathy (DN). Neutrophil to lymphocyte ratio (NLR) rather than other white cell parameters was found to be a useful inflammatory marker to predict adverse outcomes in medical and surgical conditions. Nevertheless, the value of NLR in predicting DN has not been elucidated. Method: An observational study included 338 diabetic patients, who were followed at our clinic between 2007 and 2009. We arranged our patients into tertiles according to their 2007 NLR. The primary outcome was continuous decrease of GFR >12 mL/min between 2007 and 2009 with the last GFR <60 mL/min. Result: The lowest NLR tertile had fewer patients (2.7) with primary outcome (i.e., worsening renal function) compared with middle and highest NLR tertiles, which had more patients with primary outcomes (8.7 and 11.5, respectively) with a significant p-value 0.0164. When other potential confounders were individually analyzed with NLR tertile, the NLR tertiles remained a significant predictor of poor GFR outcome in the presence of other variables (hemoglobin A1C, systolic blood pressure, diastolic blood pressure, age, and congestive heart failure with p-values 0.018, 0.019, 0.017, 0.033, and 0.022, respectively). Conclusion: NLR predicted the worsening of the renal function in diabetic patients. Further studies are needed to confirm this result.

Original languageEnglish (US)
Pages (from-to)571-576
Number of pages6
JournalRenal Failure
Volume34
Issue number5
DOIs
StatePublished - Jun 1 2012

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Neutrophils
Lymphocytes
Kidney
Blood Pressure
Diabetic Nephropathies
Observational Studies
Hemoglobins
Heart Failure
Inflammation

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine
  • Nephrology

Cite this

Azab, Basem ; Daoud, Jacques ; Naeem, Fahad Ben ; Nasr, Rabih ; Ross, Jennifer ; Ghimire, Pratima ; Siddiqui, Ayesha ; Azzi, Nadine ; Rihana, Nancy ; Abdallah, Marie ; Azzi, Nassif ; Patel, Parishram ; Kleiner, Morton ; El-Sayegh, Suzanne. / Neutrophil-to-lymphocyte ratio as a predictor of worsening renal function in diabetic patients (3-year follow-up study). In: Renal Failure. 2012 ; Vol. 34, No. 5. pp. 571-576.
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abstract = "Background: Previous studies have demonstrated the role of inflammation in diabetic nephropathy (DN). Neutrophil to lymphocyte ratio (NLR) rather than other white cell parameters was found to be a useful inflammatory marker to predict adverse outcomes in medical and surgical conditions. Nevertheless, the value of NLR in predicting DN has not been elucidated. Method: An observational study included 338 diabetic patients, who were followed at our clinic between 2007 and 2009. We arranged our patients into tertiles according to their 2007 NLR. The primary outcome was continuous decrease of GFR >12 mL/min between 2007 and 2009 with the last GFR <60 mL/min. Result: The lowest NLR tertile had fewer patients (2.7) with primary outcome (i.e., worsening renal function) compared with middle and highest NLR tertiles, which had more patients with primary outcomes (8.7 and 11.5, respectively) with a significant p-value 0.0164. When other potential confounders were individually analyzed with NLR tertile, the NLR tertiles remained a significant predictor of poor GFR outcome in the presence of other variables (hemoglobin A1C, systolic blood pressure, diastolic blood pressure, age, and congestive heart failure with p-values 0.018, 0.019, 0.017, 0.033, and 0.022, respectively). Conclusion: NLR predicted the worsening of the renal function in diabetic patients. Further studies are needed to confirm this result.",
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Azab, B, Daoud, J, Naeem, FB, Nasr, R, Ross, J, Ghimire, P, Siddiqui, A, Azzi, N, Rihana, N, Abdallah, M, Azzi, N, Patel, P, Kleiner, M & El-Sayegh, S 2012, 'Neutrophil-to-lymphocyte ratio as a predictor of worsening renal function in diabetic patients (3-year follow-up study)', Renal Failure, vol. 34, no. 5, pp. 571-576. https://doi.org/10.3109/0886022X.2012.668741

Neutrophil-to-lymphocyte ratio as a predictor of worsening renal function in diabetic patients (3-year follow-up study). / Azab, Basem; Daoud, Jacques; Naeem, Fahad Ben; Nasr, Rabih; Ross, Jennifer; Ghimire, Pratima; Siddiqui, Ayesha; Azzi, Nadine; Rihana, Nancy; Abdallah, Marie; Azzi, Nassif; Patel, Parishram; Kleiner, Morton; El-Sayegh, Suzanne.

In: Renal Failure, Vol. 34, No. 5, 01.06.2012, p. 571-576.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Neutrophil-to-lymphocyte ratio as a predictor of worsening renal function in diabetic patients (3-year follow-up study)

AU - Azab, Basem

AU - Daoud, Jacques

AU - Naeem, Fahad Ben

AU - Nasr, Rabih

AU - Ross, Jennifer

AU - Ghimire, Pratima

AU - Siddiqui, Ayesha

AU - Azzi, Nadine

AU - Rihana, Nancy

AU - Abdallah, Marie

AU - Azzi, Nassif

AU - Patel, Parishram

AU - Kleiner, Morton

AU - El-Sayegh, Suzanne

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Background: Previous studies have demonstrated the role of inflammation in diabetic nephropathy (DN). Neutrophil to lymphocyte ratio (NLR) rather than other white cell parameters was found to be a useful inflammatory marker to predict adverse outcomes in medical and surgical conditions. Nevertheless, the value of NLR in predicting DN has not been elucidated. Method: An observational study included 338 diabetic patients, who were followed at our clinic between 2007 and 2009. We arranged our patients into tertiles according to their 2007 NLR. The primary outcome was continuous decrease of GFR >12 mL/min between 2007 and 2009 with the last GFR <60 mL/min. Result: The lowest NLR tertile had fewer patients (2.7) with primary outcome (i.e., worsening renal function) compared with middle and highest NLR tertiles, which had more patients with primary outcomes (8.7 and 11.5, respectively) with a significant p-value 0.0164. When other potential confounders were individually analyzed with NLR tertile, the NLR tertiles remained a significant predictor of poor GFR outcome in the presence of other variables (hemoglobin A1C, systolic blood pressure, diastolic blood pressure, age, and congestive heart failure with p-values 0.018, 0.019, 0.017, 0.033, and 0.022, respectively). Conclusion: NLR predicted the worsening of the renal function in diabetic patients. Further studies are needed to confirm this result.

AB - Background: Previous studies have demonstrated the role of inflammation in diabetic nephropathy (DN). Neutrophil to lymphocyte ratio (NLR) rather than other white cell parameters was found to be a useful inflammatory marker to predict adverse outcomes in medical and surgical conditions. Nevertheless, the value of NLR in predicting DN has not been elucidated. Method: An observational study included 338 diabetic patients, who were followed at our clinic between 2007 and 2009. We arranged our patients into tertiles according to their 2007 NLR. The primary outcome was continuous decrease of GFR >12 mL/min between 2007 and 2009 with the last GFR <60 mL/min. Result: The lowest NLR tertile had fewer patients (2.7) with primary outcome (i.e., worsening renal function) compared with middle and highest NLR tertiles, which had more patients with primary outcomes (8.7 and 11.5, respectively) with a significant p-value 0.0164. When other potential confounders were individually analyzed with NLR tertile, the NLR tertiles remained a significant predictor of poor GFR outcome in the presence of other variables (hemoglobin A1C, systolic blood pressure, diastolic blood pressure, age, and congestive heart failure with p-values 0.018, 0.019, 0.017, 0.033, and 0.022, respectively). Conclusion: NLR predicted the worsening of the renal function in diabetic patients. Further studies are needed to confirm this result.

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