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Kidney Week

Abstract: FR-PO910

Correlation Between Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios and Progression of CKD in Elderly Patients

Session Information

  • Geriatric Nephrology
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1300 Geriatric Nephrology

Authors

  • Cardoso, Juliana M., Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Vieira, Ana Teresa Pereira, Universidade de Sao Paulo, Sao Paulo, Brazil
  • Lauar, Julia, Universidade de Sao Paulo, Sao Paulo, Brazil
  • Araujo, Luiza Karla, Universidade de Sao Paulo, Sao Paulo, Brazil
  • Freire Filho, Washington Alves, Universidade de Sao Paulo, Sao Paulo, Brazil
  • Innecchi, Mariana Leister Rocha, Universidade de Sao Paulo, Sao Paulo, Brazil
  • Moyses, Rosa M.A., Universidade de Sao Paulo, Sao Paulo, Brazil
  • Elias, Rosilene M., Universidade de Sao Paulo, Sao Paulo, Brazil
Background

The systemic inflammation associated with chronic kidney disease (CKD) increases acute-phase protein and inflammatory mediators, which has been associated with higher mortality. Neutrophil-to-lymphocyte (NLR) ratio and platelet-to-lymphocyte ratios (PLR) have been widely studied as inflammatory markers in malignancies, hypertension, heart diseases, and vascular diseases. NLR predicts CKD progression and PLR predicts mortality among hemodialysis patients. The role of NLR and PLR in predicting CKD progression, death or dialysis initiation in elderly is unknown.

Methods

We assessed the composite outcome of death/dialysis initiation and CKD progression in 139 patients with stages 4 or 5 CKD, aged 70 years or more, participants of an ongoing trial (Aging Nephropathy Study -AGNES). NLR and PLR ratios were measured at the study entry. Fast progression was defined as > 5 mL/minute/year loss of estimated glomerular filtration rate (eGFR).

Results

Average age was 83±7 years, eGFR 19.8±7.0ml/min/1.73m2, 56% men, 53% with diabetes. NLR was 2.9±1.4 and PLR was 131.6. Over time, the decline in eGFR was 2.4 (1.1, 6.2) ml/min/yr. NLR but not PLR was higher in fast progressors (p=0.021 and 0.238, respectively). NLR (p-0.028) but not PLR (p=0.077) was higher in patients who died/started dialysis (N=55, 39.6%). Logistic regression/Cox regression revealed NLR as an independent risk factor for CKD progression and death/dialysis initiation, respectively, in fully adjusted models. ROC curve defined 3.77 as the best cut-off value of NLR to predict death/dialysis initiation (specificity 88.1%).

Conclusion

NLR seems to be a good marker for mortality/dialysis initiation and also CKD progression in older patients with advanced CKD, in a higher value than that described for the general population. NLR, a non-expensive tool, should be widely used in this population to identify patients at risk.