The Relationship of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio with High Sensitivity C-Reactive Protein Level in Hemodialysis Patients

Abstract

Background: Hemodialysis (HD) is the treatment of end-stage renal disease (ESRD), which leads to increased inflammation and mortality. This study aimed to investigate the relationship of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with high sensitivity C-reactive protein (hs-CRP) levels to predict inflammatory conditions in HD patients. Materials and Methods: A total of 100 eligible maintenance HD patients referred to 22 Bahman and 17 Shahrivar hospitals in Mashhad were enrolled in this cross-sectional study. We collected demographic and clinical data, as well as values of inflammatory markers such as NLR, PLR, and hs-CRP, from the patient’s medical records. Results: Forty-six of the patients were female. The mean age of the patients was 37.96±10.29 years, and the mean duration of HD was 54.32±50 months. The mean hs-CRP levels, NLR, and PLR were 6.08±5.70 mg/L, 2.79±1.18, and 125.80±57.14, respectively. The results showed a statistically significant and direct relationship between PLR and hs-CRP levels (P=0.01). There was no correlation between NLR and hs-CRP levels (P=0.8). Additionally, PLR was inversely correlated with hs-CRP in hypertensive patients (r=-0.283, P=0.04), female patients (r=0.3, P=0.04), and patients with HD duration of less than five years (r=0.3, P=0.001). Conclusion: Based on these findings, the PLR is a useful inflammatory marker in HD patients with ESRD that correlates with hs-CRP levels. We recommend further investigations to establish its accuracy in clinical care.

Keywords

• chronic kidney disease
• c-reactive protein
• renal dialysis
• neutrophil to lymphocyte ratio
• platelet to lymphocyte ratio