The Role of Neutrophil - Lymphocyte ratio and Platelet - Lymphocyte ratio with High Sensitivity C-Reactive Protein level in patients on hemodialysis

Abstract

Abstract Background: Hemodialysis (HD) is the most common treatment for chronic kidney insufficiency that can increase inflammation and mortality in these patients. We aimed to compare the relationship of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) with high sensitivity C-reactive protein (hs-CRP) levels in predicting inflammatory conditions in HD patients. Methods: This cross-sectional study included end-stage renal disease (ESRD) patients on regular HD in the Islamic Republic of Iran. Based on patients’ records, demographic and clinical data, and inflammatory markers, including NLR, PLR, and hs-CRP, were obtained. Results: One hundred patients were enrolled, of which 46% were female. The mean age was 37.96 ± 10.29, and the mean HD time was 54.32 ± 50 months. The mean hs-CRP levels, NLR, and PLR were 6.08 ± 5.70mg/l, 2.79 ± 1.18, and 125.80 ± 57.14, respectively. Our results showed a statistically significant and direct relationship between PLR and hs-CRP levels (P = 0.01) but no correlation between NLR and hs-CRP levels (P = 0.8). In addition, PLR was correlated inversely with hs-CRP in hypertensive patients (r = -0.283, P = 0.04) and had significant relationships in the female population (r = 0.3, P = 0.04) and time of HD below five years (r = 0.3, P = 0.001). PLR is a suitable and inexpensive inflammatory marker in HD patients with ESRD, correlating with hs-CRP. Further investigations emphasizing accuracy establishment are mandated to certify its application in clinical workups.