Korean J Nephrol.  2010 Jan;29(1):46-53.

Neutrophil-to-lymphocyte Ratio as a Risk Factor for Severe Acute Kidney Injury

• Kim HW
• Jang EH

Abstract

PURPOSE
To evaluate whether neutrophil-to-lymphocyte ratio (NLR) as a marker of inflammation correlates with the severity of ischemic acute kidney injury (AKI).
METHODS
Between January 2003 and December 2008, 84 patients were diagnosed with ischemic AKI. Patients were divided into two groups (prerenal azotemia and acute tubular necrosis; ATN) and analyzed.
RESULTS
Of 84 ischemic AKI patients studied, 49 (58%) presented with ATN. NLR on admission was significantly greater in patients with ATN than that in those with prerenal azotemia (7.8+/-7.7 vs. 5.1+/- 3.7; p=0.034). There was a significant and positive correlation between NLR and age (r=0.283; p= 0.009), log C-reactive protein (r=0.409; p=0.001), and log initial and peak serum creatinine (SCr) (r= 0.242; p=0.026 and r=0.294; p=0.007, respectively). Body mass index, hemoglobin and serum albumin concentration were negatively correlated with NLR (r=-0.291; p=0.031, r=-0.254; p=0.020, and r= -0.236; p=0.032, respectively). Thirty-four (41%) patients had severe AKI (RIFLE-F, defined as an absolute increase in SCr of either > or = 0.5 mg/dL or a threefold increase from baseline, or a SCr of more than 4 mg/dL) during hospitalization. A high NLR (>7.5) was associated with the development of severe AKI in multivariate logistic regression analysis.
CONCLUSION
High levels of inflammation, as demonstrated by a high NLR, are associated with the severity of ischemic AKI.

Keyword

Acute renal failure; Inflammation; Neutrophil; Lymphocyte

MeSH Terms

Acute Kidney Injury
Azotemia
Body Mass Index
C-Reactive Protein
Creatinine
Hemoglobins
Hospitalization
Humans
Inflammation
Logistic Models
Lymphocytes
Neutrophils
Risk Factors
Serum Albumin
C-Reactive Protein
Creatinine
Hemoglobins
Serum Albumin