title: Neutrophil to lymphocyte ratio in evaluation of inflammation in patients with chronic kidney disease.
abstract: OBJECTIVE
  The current data have proven the pivotal role of inflammation in the development of atherosclerosis and cardiovascular diseases in patients with chronic kidney disease (CKD). Neutrophil to lymphocyte (N/L) ratio has increasingly been reported as a measure of systemic inflammation. This study assessed N/L ratio and investigated its associations with standard inflammatory biomarkers in different stages of CKD patients.
  
  
  METHODS
  This cross-sectional study included 30 predialysis, 40 hemodialysis, 35 peritoneal dialysis patients, and 30 healthy subjects. N/L ratio and important clinical and laboratory parameters were registered. Multivariate regression analyses were carried out to investigate the relations of N/L ratio.
  
  
  RESULTS
  N/L ratio was significantly higher in each patient group compared to the healthy subjects (for all, p < 0.001). It was positively correlated with interleukin-6 (IL-6) (r = 0.393, p < 0.001) and high-sensitivity C-reactive protein (hs-CRP) (r = 0.264, p = 0.002) levels and negatively correlated with hemoglobin (r = -0.271, p = 0.001), serum albumin (r = -0.400, p < 0.001), and high-density lipoprotein (HDL) cholesterol levels (r = -0.302, p < 0.001). In CKD patients with hypertension (HT), higher N/L ratio was detected when compared to those without HT (p = 0.006). Having CKD, the presence of HT, serum albumin, HDL-cholesterol, IL-6, and hs-CRP levels were found to be independent predictors of the ratio after adjusting for significant covariates (p < 0.001).
  
  
  CONCLUSIONS
  An easy and inexpensive laboratory measure of N/L ratio might provide significant information regarding inflammation in CKD including predialysis and dialysis patients.
authors.affiliation: Department of Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Gülay Ulusal
authors.initials: GU
authors.lastname: Okyay
authors.forename: Salih
authors.initials: S
authors.lastname: Inal
authors.forename: Kürşad
authors.initials: K
authors.lastname: Oneç
authors.forename: Ramazan Erdem
authors.initials: RE
authors.lastname: Er
authors.forename: Ozge
authors.initials: O
authors.lastname: Paşaoğlu
authors.forename: Hatice
authors.initials: H
authors.lastname: Paşaoğlu
authors.forename: Ulver
authors.initials: U
authors.lastname: Derici
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Erten
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein