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Kidney Week

Abstract: PO0091

Usefulness of the Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Community-Acquired AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Pena Porta, Jose M., Nephrology Service. Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
  • Castellano, Almudena, Nephrology Service. Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
  • Coscojuela Otto, Ana, Nephrology Service. Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
  • Gascó, José Ferreras, Nephrology Service. Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
  • Tomás, Alejandro, Nephrology Service. Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
  • Inigo Gil, Pablo J., Nephrology Service. Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
  • Alvarez lipe, Rafael, Nephrology Service. Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
Background

The neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios have been identified as markers of inflammation and endothelial dysfunction. To date, its usefulness as prognostic markers in community-acquired acute kidney injury (CA-AKI) has not been evaluated.

Methods

We established a cohort of patients with CA-AKI admitted to our Nephrology service from January 2010 to February 2015. NLR and PLR ratios were obtained with the first analysis performed.

Results

We studied 308 patients with CA-AKI, 58 % were men, mean age 73.22 . Etiology of CA-AKI: prerenal 69.5%; renal 23.1%; obstructive 7,5%. AKI KDIGO stages: I, 14.6%; II, 11%; III 74.4%. CKD was detected in 68.8%.17,15% of cases required hemodialysis and 12,3 % died.
Mean NLR was 9.14 ± 8,47. Mean PLR was 236,99 ± 228,41. NLR according to etiology was: prerenal 8,55±6,8; renal 9,37±9,8; obstructive 13,99±14,82 (significant differences between obstructive and prerenal). PLR according to etiology: prerenal 228,31±216,34; renal 236,15±233,77; obstructive 320,37±304,89 (non-significant differences). Within the group prerenal, 79 cases were complicated by acute tubular necrosis (ATN). These cases presented a higher NLR (10,7±10,28 vs NLR 7,8±5,6; p=0,026). There were no significant differences between the PLR of both grups.
The NLR showed a significant correlation with the peak creatinine (r= 0,186; p = 0,001) and with serum albumin (r= -0,237; p < 0,001). The PLR also showed the same correlations (r= 0,134, p = 0,018 and r = 0,165, p= 0,07).The NLR, but not the PLR, was associated with the length of hospital stay (multiple linear regression analysis). Through a multivariate binary logistic regression analysis, the variables that were independently associated with mortality during admission were the Liaño individual severity index and the NLR (OR 1,060; IC 95 % 1.014 – 1,108).
The best cut-off point of the NLR to predict mortality was 6,68 (AUC 0,584; sensitivity 0.60; specificity 0.58; Youden index 0.178)

Conclusion

In our CA-AKI patients cohort, the NLR was associated with the morbidity and the mortality. More studies are need to confirm this finding, but the easiness of obtaining it and its economic cost make it cost-effective, giving the NLR a leading role in assessing the risk of CA-AKI.