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Abstract: TH-PO052

Utilizing Neutrophil Lymphocyte Ratio to Detect Early AKI

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention


  • Khan, Asif, Staten Island University Hospital, Brooklyn, New York, United States
  • El-Charabaty, Elie, Staten Island University Hospital, Brooklyn, New York, United States
  • El Sayegh, Suzanne E., Staten Island University Hospital, Brooklyn, New York, United States

The ability to detect early Acute Kidney Injury (AKI) prior to elevation of Cr has always been a challenge to physician. Traditionally, serum Cr level is used to diagnose AKI. However, it has been shown to be poor predictor of AKI occurrence. Multiple inflammatory markers for AKI have been studied, but they are expensive and their clinical values remain limited. NLR has been found to be strongly associated with inflammatory states in last decade, thus can potentially be used as marker for AKI. Our primary objective is to investigate the role of NLR in prediction of early AKI prior elevation of Cr. We compared NLR’s predictive power of AKI in both inflammatory and non-inflammatory conditions.


Retrospective study included 413 patients with age ≥ 18 who were admitted with the diagnosis of pneumonia without AKI (PWOA) and those admitted with pneumonia who developed AKI (PWA) as well as the patients admitted with diagnosis of heart failure without AKI (HFWOA) and those admitted with heart failure who developed AKI (HFWA). NLR and renal function were compared from 3 days before Day 0, and 3 days after Day 0. Day 0 represents as the day of diagnosis of AKI in PWA and HFWA groups; Day 0 is also represented by day of diagnosis of pneumonia or heart failure in PWOA and HFWOA groups. Subjects with ESRD, contrast induced AKI, drug induced AKI, hematologic proliferative diseases, on immunosuppressive agents or chronic steroid were excluded from the study.


Patients in PWOA group has significantly hight NLR value (p value <0.0001) and longer lenght of stay (pvalue: <0.01) when compared to HFWOA, owing to higher sensitivity of NLR. Significant rise in NLR was also observed 72 hours earlier than serum Cr in PWA group (p value <0.0001). Thus, NLR not only strongly associated with AKI rather than infectious process, but also able to predict AKI significantly earlier than serum Cr level.


Our result suggests that NLR that was found to be associated with inflammatory conditions, can potentially be utilized as a marker to detect early AKI.