The Association of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio to the Prognosis of Acute Kidney Injury Patients

Abstract

Abstract Background Acute kidney injury (AKI) is an increasingly common problem facing clinicians, especially nephrologists, intensive care physicians, general physicians and surgeons. Acute kidney injury is a heterogeneous group of conditions characterized by a sudden decrease in glomerular filtration rate, manifested by an increase in serum creatinine concentration or oliguria, and classified by stage and cause. Aim of the Work The aim of the study was to evaluate the prognostic ability of the Neutrophil to Lymphocyte ratio, Platelet to Lymphocyte ratio and neutrophil to lymphocyte and platelet ratio in adult patients with acute kidney injury with various etiologies and to evaluate their role in the prediction of both morbidity and mortality over period of three months. Patients and Methods To achieve this goal, we conducted this study on 102 patients who developed acute kidney injury during hospital admission in Ain Shams University hospitals. Results he study found no significant differences between PLR and NLP ratios among different AKI stages. NLP ratio showed an inverse correlation with serum creatinine and a positive correlation with estimated Glomerular Filtration Rate (eGFR), while PLR did not show significant correlation. NLP ratio had the ability to predict the outcome of AKI with significant differences between mortality and recovery cases, while PLR did not have significant ability to predict outcome. NLP ratio showed high sensitivity and specificity in predicting the need for vasopressors, mechanical ventilation, or hemodialysis, while PLR had moderate sensitivity and high specificity in predicting recovery. The study had some limitations, including not enrolling non-AKI control group and not evaluating the effect of certain treatments on the studied markers. Conclusion The study had the advantages of being conducted on relatively large sample size and included patients of variable causes of admission. The included patients had also variable causes of AKI and of different AKI stages. The study had some limitations as we did not enroll non- AKI control group. We did not evaluate the effect of certain treatment modalities as some antibiotics or interventions on the studied markers.