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. 2019 Mar 15;17(1):86.
doi: 10.1186/s12967-019-1808-4.

Neutrophil-to-lymphocyte ratio and incident end-stage renal disease in Chinese patients with chronic kidney disease: results from the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE)

Qiongjing Yuan  1 , Jinwei Wang  2 , Zhangzhe Peng  1 , Qiaoling Zhou  1 , Xiangcheng Xiao  1 , Yanyun Xie  1 , Wei Wang  1 , Ling Huang  1 , Wenbin Tang  1 , Danni Sun  1 , Luxia Zhang  2   3 , Fang Wang  2 , Ming-Hui Zhao  2   4 , Lijian Tao  1 , Kevin He  5 , Hui Xu  6 ; C-STRIDE study group
Affiliations

Neutrophil-to-lymphocyte ratio and incident end-stage renal disease in Chinese patients with chronic kidney disease: results from the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE)

Qiongjing Yuan et al. J Transl Med. .

Abstract

Background: Chronic kidney disease (CKD) leads to end-stage renal failure and cardiovascular events. An attribute to these progressions is abnormalities in inflammation, which can be evaluated using the neutrophil-to-lymphocyte ratio (NLR). We aimed to investigate the association of NLR with the progression of end stage of renal disease (ESRD), cardiovascular disease (CVD) and all-cause mortality in Chinese patients with stages 1-4 CKD.

Methods: Patients with stages 1-4 CKD (18-74 years of age) were recruited at 39 centers in 28 cities across 22 provinces in China since 2011. A total of 938 patients with complete NLR and other relevant clinical variables were included in the current analysis. Cox regression analysis was used to estimate the association between NLR and the outcomes including ESRD, CVD events or all-cause mortality.

Results: Baseline NLR was related to age, hypertension, serum triglycerides, total serum cholesterol, CVD history, urine albumin to creatinine ratio (ACR), chronic kidney disease-mineral and bone disorder (CKD-MBD), hyperlipidemia rate, diabetes, and estimated glomerular filtration rate (eGFR). The study duration was 4.55 years (IQR 3.52-5.28). Cox regression analysis revealed an association of NLR and the risk of ESRD only in patients with stage 4 CKD. We did not observe any significant associations between abnormal NLR and the risk of either CVD or all-cause mortality in CKD patients in general and CKD patients grouped according to the disease stages in particular.

Conclusion: Our results suggest that NLR is associated with the risk of ESRD in Chinese patients with stage 4 CKD. NLR can be used in risk assessment for ESRD among patients with advanced CKD; this application is appealing considering NLR being a routine test. Trial registration ClinicalTrials.gov Identifier NCT03041987. Registered January 1, 2012. (retrospectively registered) ( https://www.clinicaltrials.gov/ct2/show/NCT03041987?term=Chinese+Cohort+Study+of+Chronic+Kidney+Disease+%28C-STRIDE%29&rank=1 ).

Keywords: Chronic kidney disease (CKD); End stage of renal disease (ESRD); Neutrophil-to-lymphocyte ratio (NLR).

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Maximally selected log-rank statistics for cutoff point of NLR
Fig. 2
Fig. 2
Kaplan–Meier curve for ESRD events according to binary of NLR
See this image and copyright information in PMC

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