Prognostic importance of platelet/lymphocyte ratio and neutrophil/lymphocyte ratio in proteinuria associated with primary glomerular diseases

Abstract

Objective: Proteinuria is associated with inflammation, endothelial dysfunction, platelet activation, and progression of kidney disease. The biological mechanisms by which platelet/lymphocyte rate (PLR) and neutrophil/lymphocyte rate (NLR) variables play a role in mediating protein excretion are not fully known. Here we aimed to compare NLR and PLR variables between patients with the primary glomerular disease (PPGD) with normal estimated glomerular filtration rate (eGFR) and healthy individuals (HIs). We divided the primary glomerular disease (PGD) participants into three sub-groups according to the level of proteinuria. In addition, a comparison was made between the sub-groups of patients with PGD in terms of these variables. Methods: This cross-sectional, double arm, single center retrospective study was performed between January 2019 and April 2020. Serum platelet, total, and differential leukocyte analyses were evaluated using an automated cell counter. Biochemical analysis and 24-hour urinalysis in order to measure protein excretion and creatinine (Cr) clearance were performed using a chemistry analyzer. Of 225 participants in the study, 111 were patients with PGD, and 114 were HIs. Results: A statistically significant difference was found when compared with PPGD and HI participants in terms of red blood cell (RBC), hemoglobin (HGB), white blood cell (WBC), platelet, neutrophil, NLR, and PLR variables. PPGDs revealed higher median C-reactive protein (CRP) and lower median albumin levels compared to HIs. Age, gender, urea, Cr, CRP, WBC, RBC, HGB, platelet, neutrophil, lymphocyte, NLR, and PLR variables between the sub-groups of patients with PGD were not statistically significant. But, there was only a difference between the sub-groups of patients with PGD in terms of albumin levels. Conclusions: Our data suggested that PLR and NLR can be used as predictors in PPGDs. Higher median CRP and lower median albumin levels were also associated with proteinuria in PPGDs.