Neutrophil-to-lymphocyte, platelet-to-lymphocyte ratios and their association with atherogenic index of plasma in sickle cell nephropathy

Abstract

Background/Objectives: Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios (NLR and PLR) were introduced as cheap and readily assessed biologic markers of subclinical inflammation. There are few studies that have evaluated NLR and PLR as prognostic markers of proteinuria in sickle cell anemia (SCA) patients. This study seeks to evaluate NLR and PLR in SCA patients with proteinuria, impaired kidney function and to ascertain whether there exist relationship between the leukocyte ratios and atherogenic index of plasma. Materials and Methods: The NLR, PLR, and atherogenic index were calculated from full blood count and lipid profile parameters determined from fasting blood specimens collected from 200 confirmed SCA patients and 100 control subjects with normal hemoglobin (Hb). Results: The NLR and PLR values were significantly higher (P < 0.001) in SCA patients compared with control subjects with normal Hb. Similarly, NLR and PLR values were significantly higher (P < 0.001) in SCA patients with proteinuria and those with impaired kidney function than without proteinuria and normal controls. A significantly positive association was observed between NLR and atherogenic index of plasma (AIP) in SCA patients with proteinuria (P < 0.05) and those with impaired kidney function (P < 0.02) while significant association was observed between PLR and AIP in SCA with impaired kidney function (P < 0.05). Conclusion: The leukocyte ratios may be useful as prognostic markers for the presence of proteinuria in SCA patients and impaired kidney function as well as cardiovascular risk event. The need to have reference cut-off values of NLR and PLR is hereby suggested to better identify those patients at risk in the management SCA patients.

Keywords

• Atherogenic index of plasma
• neutrophil-to-lymphocyte ratio
• platelet-to-lymphocyte ratio
• sickle cell disease