Prognostic Value of Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio for Renal Outcomes in Patients with Rapidly Progressive Glomerulonephritis
Prognostic Value of Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio for Renal Outcomes in Patients with Rapidly Progressive Glomerulonephritis
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DOI：
10.3390/jcm9041128
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发表时间：
2020-04-01
影响因子：
3.9
通讯作者：
Isomoto, Hajime
中科院分区：
文献类型：
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作者：
Mae, Yukari;Takata, Tomoaki;Isomoto, Hajime
背景资料：快速进展性肾小球肾炎（RPGN）是一种以肾功能快速下降为特征的综合征，通常导致终末期肾病。尽管在开始免疫抑制治疗前预测RPGN的肾脏预后很重要，但目前尚无简单的预后指标。本研究的目的是探讨RPGN患者的嗜中性粒细胞与淋巴细胞比率（NLR）和血小板与淋巴细胞比率（PLR）与肾脏预后的关系。方法：44例临床诊断为RPGN并接受肾活检的患者入选。研究了NLR和PLR与1年后肾脏结局的关系。结果如下：与需要维持性血液透析的患者相比，肾功能保留的患者的NLR和PLR显著更高（分别为p < 0.05和p < 0.01）。肾脏结局的截止值为NLR 4.0和PLR 137.7（曲线下面积分别为0.782和0.819;灵敏度分别为78.4%和89.2%;特异性分别为71.4%和71.4%）。此外，NLR 5.0可以预测需要血液透析患者的肾损伤恢复（曲线下面积，0.929;灵敏度，83.3%;特异性，85.7%）。结论：NLR和PLR可作为预测RPGN患者肾脏预后的候选指标。
Background: Rapidly progressive glomerulonephritis (RPGN) is a syndrome characterized by a rapid decline in renal function that often causes end-stage renal disease. Although it is important to predict renal outcome in RPGN before initiating immunosuppressive therapies, no simple prognostic indicator has been reported. The aim of this study was to investigate the associations of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to renal outcomes in patients with RPGN. Methods: Forty-four patients with a clinical diagnosis of RPGN who underwent renal biopsy were enrolled. The relationships between NLR and PLR and renal outcome after 1 year were investigated. Results: NLR and PLR were significantly higher in patients with preserved renal function in comparison to patients who required maintenance hemodialysis (p < 0.05 and p < 0.01, respectively). An NLR of 4.0 and a PLR of 137.7 were the cutoff values for renal outcome (area under the curve, 0.782 and 0.819; sensitivity, 78.4% and 89.2%; specificity, 71.4% and 71.4%, respectively). Furthermore, an NLR of 5.0 could predict recovery from renal injury in patients requiring hemodialysis (area under the curve, 0.929; sensitivity, 83.3%; specificity, 85.7%). Conclusion: NLR and PLR could be candidates for predicting renal outcomes in patients with RPGN.