Neutrophil-to-lymphocyte ratio as an independent inflammatory indicator for poor renal prognosis in adult IgA vasculitis with nephritis.
Neutrophil-to-lymphocyte ratio as an independent inflammatory indicator for poor renal prognosis in adult IgA vasculitis with nephritis.
复制标题
中性粒细胞与淋巴细胞比率作为成人 IgA 血管炎肾炎肾预后不良的独立炎症指标。
DOI：
10.1016/j.intimp.2022.109178
复制
发表时间：
2022
影响因子：
5.6
通讯作者：
Hong Zhang
中科院分区：
文献类型：
--
作者：
Qianqian Li;S. Shi;Lijun Liu;J. Lv;Li Zhu;Hong Zhang
背景皮肤局限性IgA病毒（IgAV）患者多表现为自限性疾病，预后良好，而成人伊加血管炎伴肾炎（IgAV-N）表现为严重表型，预后差。以往的研究表明，嗜中性粒细胞与淋巴细胞比率（NLR）是预测儿童IgAV患者全身受累的炎症指标。在这项研究中，我们专注于成人IgAV-N患者，探讨NLR与疾病表型和长期肾预后的关系。方法在这项研究中，245 IgAV-N患者，1151 IgAN患者和251名健康对照。结果IgAV-N患者的白色细胞（WBC）、中性粒细胞（NE）、血小板-淋巴细胞比率（PLR）和NLR水平较健康对照组升高，而淋巴细胞（LY）水平较健康对照组降低。与临床和病理特征匹配的IgAN患者相比，IgAV-N患者仍显示出较高的WBC、NE和NLR水平。NLR对IgAV-N的诊断性能最好，ROC曲线下面积最大（0.738）。高NLR组（>2.41）IgAV-N患者的基线表现较重，急性病变较低NLR组（≤2.41）多。77例定期随访的患者用于生存分析。在调整已知危险因素后，NLR水平仍是成人IgAV-N患者肾功能不良的独立危险因素（HR，1.913，95%CI，1.314 ~ 2.787，P = 0.001）。结论NLR水平与IgAV-N患者的临床和病理表型相关，NLR可能是成人IgAV-N患者肾功能不良的独立危险因素。
BackgroundSkin-limited IgAV patients usually present self-limiting disease and good prognosis, while adult IgA vasculitis with nephritis (IgAV-N) present severe phenotype and poor prognosis. Previous studies showed that neutrophil-to-lymphocyte ratio (NLR) was an inflammatory indicator for predicting systemic involvement in children IgAV patients. In this study, we focused on adult IgAV-N patients to explore the relationship of NLR with disease phenotype and long-term renal prognosis.MethodsIn this study, 245 IgAV-N patients, 1151 IgAN patients and 251 healthy controls were recruited. Composite endpoint was defined as 30% eGFR declined or end stage kidney disease.ResultsIgAV-N patients presented increased white blood cells (WBC), neutrophils (NE), platelet-to-lymphocyte ratio (PLR), and NLR levels, while decreased lymphocyte (LY) than healthy controls. When compared to clinical and pathological features matched IgAN patients, IgAV-N patients still showed higher WBC, NE, and NLR levels. NLR showed the best performance for the diagnosis of IgAV-N with the highest area under the ROC curves (0.738). IgAV-N patients in high NLR group (>2.41) presented with sever baseline manifestations and more acute pathological lesions than low NLR group (≤2.41). 77 patients with regular follow-up were used for survival analysis. After adjusting some well-known risk factors, NLR levels remained as an independent risk factor for poor renal outcome in adult patients with IgAV-N (HR, 1.913; 95% CI, 1.314 to 2.787,P= 0.001).ConclusionsNLR levels were associated with the clinical and pathological phenotypes, and NLR may serve as an independent risk factor for poor renal outcome in adult IgAV-N patients.
影响因子：
19.6
作者：
Stevens LA;Claybon MA;Schmid CH;Chen J;Horio M;Imai E;Nelson RG;Van Deventer M;Wang HY;Zuo L;Zhang YL;Levey AS
通讯作者：
Levey AS