Neutrophil to lymphocyte ratio independently predicts cardiovascular events in patients with chronic kidney disease

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dc.contributor.authorSolak, Yalcin
dc.contributor.authorYilmaz, Mahmut Ilker
dc.contributor.authorSonmez, Alper
dc.contributor.authorSaglam, Mutlu
dc.contributor.authorCakir, Erdinc
dc.contributor.authorUnal, Hilmi Umut
dc.contributor.authorGok, Mahmut
dc.date.accessioned2020-03-26T18:42:37Z
dc.date.available2020-03-26T18:42:37Z
dc.date.issued2013
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractIncreased inflammation is common in patients with chronic kidney disease (CKD) and is associated with increased adverse cardiovascular events (CVE). Neutrophil-to-lymphocyte ratio (NLR) was used to predict survival in patients with acute coronary syndrome. We aimed to evaluate predictive ability of NLR in CKD patients. 225 subjects with stage 3-5 CKD were followed for a mean of 39 months. Fatal and nonfatal CVE were recorded during this period. NLR at baseline was determined from complete blood count differential. Endothelial dysfunction (flow-mediated dilation, FMD), hsCRP and insulin resistance were determined. We investigated if NLR could predict development of fatal and nonfatal CVE. We also looked at how NLR and its individual components change across CKD stages and whether NLR is related to CRP, insulin resistance and endothelial dysfunction. There were 70, 74 and 81 patients in groups of CKD stage-3, stage-4 and stage-5, respectively. Median NLR was 2.81. NLR showed a significant increase from stage 3 to stage 5. NLR was inversely associated with FMD independent of hsCRP. 14 fatal and 52 nonfatal CVE occurred during follow-up period. NLR could predict composite CVE independent of insulin resistance and hsCRP. Increased NLR over 2.81 was related to a significantly decreased survival time (log-rank Chi-square = 14.833, P < 0.0001). A cutoff value for NLR a parts per thousand yen3.76 could predict development of composite CVE with 80.3 % sensitivity and 91.8 % specificity. NLR is independently related to endothelial dysfunction and could predict composite cardiovascular endpoints independent of traditional confounding factors in patients with moderate to severe CKD.en_US
dc.description.sponsorshipSwedish Research CouncilSwedish Research Council; ERA-EDTA fellowship programen_US
dc.description.sponsorshipDr. Juan J. Carrero acknowledges grant support from the Swedish Research Council. Dr. A. Gaipov received grant support from the ERA-EDTA fellowship program. No sources of funding were used to conduct this study or prepare this manuscript.en_US
dc.identifier.doi10.1007/s10157-012-0728-xen_US
dc.identifier.endpage540en_US
dc.identifier.issn1342-1751en_US
dc.identifier.issn1437-7799en_US
dc.identifier.issue4en_US
dc.identifier.pmid23180042en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage532en_US
dc.identifier.urihttps://dx.doi.org/10.1007/s10157-012-0728-x
dc.identifier.urihttps://hdl.handle.net/20.500.12395/29671
dc.identifier.volume17en_US
dc.identifier.wosWOS:000323511000008en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSPRINGERen_US
dc.relation.ispartofCLINICAL AND EXPERIMENTAL NEPHROLOGYen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectCardiovascular eventsen_US
dc.subjectChronic kidney diseaseen_US
dc.subjectEndothelial dysfunctionen_US
dc.subjectNeutrophil to lymphocyte ratioen_US
dc.titleNeutrophil to lymphocyte ratio independently predicts cardiovascular events in patients with chronic kidney diseaseen_US
dc.typeArticleen_US

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