Association between neutrophil-lymphocyte & platelet lymphocyte ratios with prognosis & mortality in rapidly progressive glomerulonephritis
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2019
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Background & objectives: Rapidly progressive glomerulonephritis (RPGN) is a clinical syndrome manifested by features of nephritic syndrome and progressive loss of renal function over a short time. The objective of this study was to investigate the relationship between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and prognostic factors and pathological findings of renal biopsy in RPGN. Methods: Consecutive newly diagnosed RPGN patients who had follow up for at least six months were retrospectively analyzed. The estimated glomerular filtration rate (EGFR) was calculated. Albumin, C-reactive protein (CRP) levels and CRP/albumin ratio were also calculated. Results: Fifty four patients were included in the study. The mean age was 48.92±20.12 years. Clinicopathological diagnosis was pauci-immune glomerulonephritis (GN) in 40 while two had postinfectious GN, six systemic lupus erythematosus, three IgA nephropathy, two Henoch-Schönlein purpura and one membranoproliferative GN. The mean NLR was 7.02±6.34 and mean PLR was 273.90±39.15. Positive correlations between NLR and CRP levels (P=0.009, r=0.511) and CRP/albumin ratios (P=0.005, r=0.542) were observed. PLR and CRP/albumin ratios (P=0.041, r=0.412) were correlated positively. The per cent of fibrocellular crescents was negatively correlated with NLR (P=0.019, r=-0.291), and positively correlated with the lymphocyte count (P=0.05, r=0.256). In secondary crescentic subgroup, the per cent of fibrinoid necrosis had a positive correlation with PLR (P=0.013, r=0.642). Both NLR (P=0.036) and PLR (P=0.051) detected at the first month of the treatment period, were observed to be significantly correlated with mortality. Interpretation & conclusions: This study showed that NLR could predict mortality in patients with RPGN; correlated with systemic inflammation; showed a negative correlation with the per cent of fibrocellular crescents and could be regarded as a measure of glomerular inflammatory state. Moreover, PLR may be considered to be an indicator of disease severity in acute phase of crescentic GN. © 2019 Indian Journal of Medical Research.
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Adult , Aged , C-Reactive Protein , Female , Glomerulonephritis , Humans , Kidney , Leukocyte Count , Lymphocytes , Male , Middle Aged , Neutrophils , Platelet Count , Prognosis , albumin , C reactive protein , corticosteroid , creatinine , cyclophosphamide , ferritin , neutrophil cytoplasmic antibody , sodium , glucose , C reactive protein , adult , albumin blood level , anaphylactoid purpura , antibody blood level , Article , controlled study , corticosteroid therapy , creatinine blood level , disease association , estimated glomerular filtration rate , female , ferritin blood level , follow up , hematocrit , hemodialysis , human , human tissue , immunofluorescence , immunoglobulin A nephropathy , kidney biopsy , kidney necrosis , lymphocyte count , major clinical study , male , membranoproliferative glomerulonephritis , middle aged , mortality , neutrophil lymphocyte ratio , platelet lymphocyte ratio , prognosis , protein blood level , rapidly progressive glomerulonephritis , remission , retrospective study , sodium blood level , systemic lupus erythematosus , Wegener granulomatosis , clinical outcome , diastolic blood pressure , disease activity , disease severity , glomerulonephritis , hematological parameters , hematuria , hemoglobin blood level , histopathology , immunofluorescence test , infection complication , inflammation , kidney function , leukocyte count , mortality rate , neutrophil count , platelet count , predictive value , proteinuria , rapidly progressive glomerulonephritis , systolic blood pressure , treatment duration , treatment response , urea nitrogen blood level , aged , blood , glomerulonephritis , kidney , leukocyte count , lymphocyte , mortality , neutrophil , pathology , platelet count