Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in evaluation of inflammation and nutritional Status in pre dialysis chronic kidney disease patients

Abstract

Case-control study of 60 non-dialyzed CKD patients and 30 healthy volunteers as controls matched to the patients, all patients included in this study are : above 18 years old, attended outpatient department of Ain shams university hospitals diagnosed as CKD staging from 3 to 5 according to MDRD equation, and not on maintenance HD, patient who had fever or clinical evidence of infection or major surgery during last 3moths, advanced liver disease, decompensated heart diseases, chronic lung disease, malignancy, and had intestinal malabsorption syndrome were excluded from the study . GFR was calculated by modification of diet in renal disease (MDRD)) equation: eGFR (mL/min/1.73 m2) = 30.849 × (Scr)-1.154 × (Age)-0.203 × (0.742 if female) × (1.212 if black) and the total staging is done according to KDOQI and KDIGO 2012 containing GFR and albuminuria categories. Detailed medical history was taken including duration and cause of CKD, presence of other co-morbidities and drug history, full clinical examination including BP measurement and nutritional status assessment including protein & energy intake, BMI, MAC, TSF, MAMC, using of m-SGA and laboratory measurements including ( CBD, DLC, BUN, creatinine, P, K, Na, T. Ca, PTH, T.cholesterol,TG, s. albumin,transferrin, ferritin, TIBC, hs-CRP and ACR) NLR calculated by dividing neutrophil count to lymphocyte count and PLR by dividing platelet count to lymphocyte count . In this study we aimed to investigate the clinical value of NLR and PLR as inflammatory markers in evaluation of malnutrition in non- dialyzed CKD patients .