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      Associations between neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, albuminuria and uric acid and the estimated glomerular filtration rate in hypertensive patients with chronic kidney disease stages 1–3


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          The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), albuminuria and uric acid are known to be independent predictors of hypertension and cardiovascular mortality. However, to date, no study has been conducted describing the relationships between the NLR, PLR and estimated glomerular filtration rate (eGFR) in hypertensive patients with chronic kidney disease (CKD) who do not require renal replacement therapy.

          Material and methods

          This prospective study included 271 patients with essential hypertension and eGFR ≥ 30 ml/min/1.73 m 2. The patients were divided into two groups: those with CKD stages 1 and 2 and those with stage 3. We used the complete blood count to calculate the NLR and PLR, and we measured the albuminuria and uric acid levels. Then, we studied their associations with the eGFR and their potential uses as independent risk factors for renal damage.


          The NLR, albuminuria and uric acid were higher in patients with CKD stage 3 than in those with stages 1 and 2 ( p = 0.013, p = 0.001 and p = 0.001, respectively). However, no significant difference was detected in the PLR. In stage 3 patients, albuminuria and uric acid were found to be independent risk factors affecting the eGFR ( p = 0.042 and p = 0.001, respectively). However, the effects of the NLR and PLR on the eGFR were not significant ( p = 0.104 and p = 0.578, respectively).


          The NLR, similar to albuminuria and uric acid, the NLR was found to be a specific marker for CKD stage 3 patients. However, the NLR and PLR did not act as independent risk factors affecting the eGFR.

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          Most cited references26

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          Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome.

          The neutrophil/lymphocyte ratio (NLR) has recently been described as a predictor of mortality in patients who undergo percutaneous coronary intervention. The aim of this study was to investigate the utility of admission NLRs in predicting outcomes in patients with acute coronary syndromes (ACS). A total of 2,833 patients admitted to the University of Michigan Health System with diagnoses of ACS from December 1998 to October 2004 were followed. Patients were divided into tertiles according to NLR. The primary end point was all-cause in-hospital and 6-month mortality. The ACS cohort comprised 564 patients with ST-segment elevation myocardial infarctions and 2,269 patients with non-ST-segment elevation ACS. Patients in tertile 3 had higher in-hospital (8.5% vs 1.8%) and 6-month (11.5% vs 2.5%) mortality compared with those in tertile 1 (p <0.001). After adjusting for Global Registry of Acute Coronary Events risk profile, patients in the highest tertile were at an exaggerated risk for in-hospital (odds ratio 2.04, p = 0.013) and 6-month (odds ratio 3.88, p <0.001) mortality. Admission NLR is an independent predictor of in-hospital and 6-month mortality in patients with ACS. This relatively inexpensive marker of inflammation can aid in the risk stratification and prognosis of patients diagnosed with ACS.
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            Flavonoids as anti-inflammatory agents: implications in cancer and cardiovascular disease.

            Chronic inflammation is being shown to be increasingly involved in the onset and development of several pathological disturbances such as arteriosclerosis, obesity, diabetes, neurodegenerative diseases and even cancer. Treatment for chronic inflammatory disorders has not been solved, and there is an urgent need to find new and safe anti-inflammatory compounds. Flavonoids belong to a group of natural substances occurring normally in the diet that exhibit a variety of beneficial effects on health. The anti-inflammatory properties of flavonoids have been studied recently, in order to establish and characterize their potential utility as therapeutic agents in the treatment of inflammatory diseases. Several mechanisms of action have been proposed to explain in vivo flavonoid anti-inflammatory actions, such as antioxidant activity, inhibition of eicosanoid generating enzymes or the modulation of the production of proinflammatory molecules. Recent studies have also shown that some flavonoids are modulators of proinflammatory gene expression, thus leading to the attenuation of the inflammatory response. However, much work remains to be done in order to achieve definitive conclusions about their potential usefulness. This review summarizes the known mechanisms involved in the anti-inflammatory activity of flavonoids and the implications of these effects on the protection against cancer and cardiovascular disease.
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              Preoperative hematologic markers as independent predictors of prognosis in resected pancreatic ductal adenocarcinoma: neutrophil-lymphocyte versus platelet-lymphocyte ratio.

              The objective of this study was to investigate whether the preoperative hematologic markers, the platelet-lymphocyte ratio (PLR), or the neutrophil-lymphocyte ratio (NLR) ratio are significant prognostic indicators in resected pancreatic ductal adenocarcinoma. A total of 84 patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma over a 10-year period were identified from a retrospectively maintained database. The preoperative NLR was found to be a significant prognostic marker (P = .023), whereas PLR had no significant relationship with survival (P = .642) using univariate Cox survival analysis. The median overall survival in patients with an NLR of 4.0 (n = 12) (log rank, P = .016). The NLR retained its significance on multivariate analysis (P = .039) along with resection margin status (P = .001). The preoperative NLR represents a significant independent prognostic indicator in patients with resected pancreatic ductal adenocarcinoma, whereas PLR does not. 2010 Elsevier Inc. All rights reserved.

                Author and article information

                Arch Med Sci
                Arch Med Sci
                Archives of Medical Science : AMS
                Termedia Publishing House
                11 June 2018
                September 2019
                : 15
                : 5
                : 1232-1239
                Department of Internal Medicine, Medical Faculty, University of Karabuk, Karabuk, Turkey
                Author notes
                Corresponding author: Nurhayat Ozkan Sevencan PhD, Department of Internal Medicine, Medical Faculty, University of Karabuk, 78100 Karabuk, Turkey. Phone/fax: +90 5053961458. E-mail: dr_nurhayat@ 123456hotmail.com
                Copyright: © 2018 Termedia & Banach

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                : 03 March 2018
                : 20 May 2018
                Clinical Research

                neutrophil/lymphocyte ratio,platelet/lymphocyte ratio,uric acid,albuminuria,estimated glomerular filtration rate,chronic kidney disease


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