Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic biomarkers of proteinuria and CKD severity: A cross-sectional study

Objectives: Chronic kidney disease (CKD) is characterized by a prolonged decline in kidney function, defined by an estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73 m² for over 3 months. Persistent, low-grade systemic inflammation is critical to CKD progression and associated with hig...

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Main Authors: Fatima Khurshid, Shaikha Amjad, Muhammad Talha, Zainab Nadeem, Mahnoor Sohail, Muhammad Ahmad, Madiha Mumtaz
Format: Article
Language:English
Published: South Kazakhstan Medical Academy 2025-06-01
Series:Central Asian Journal of Medical Hypotheses and Ethics
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Online Access:https://cajmhe.com/index.php/journal/article/view/460
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author Fatima Khurshid
Shaikha Amjad
Muhammad Talha
Zainab Nadeem
Mahnoor Sohail
Muhammad Ahmad
Madiha Mumtaz
author_facet Fatima Khurshid
Shaikha Amjad
Muhammad Talha
Zainab Nadeem
Mahnoor Sohail
Muhammad Ahmad
Madiha Mumtaz
author_sort Fatima Khurshid
collection DOAJ
description Objectives: Chronic kidney disease (CKD) is characterized by a prolonged decline in kidney function, defined by an estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73 m² for over 3 months. Persistent, low-grade systemic inflammation is critical to CKD progression and associated with higher mortality. This study aims to evaluate the role of Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte ratio (PLR) as hematological inflammatory biomarkers across different stages of CKD to observe their trends in relation to proteinuria and assess CKD severity. Materials and Methods: This cross-sectional study was conducted at a Tertiary Care Hospital, with 188 patients who presented with CKD, between May 2024 and September 2024. Laboratory data included absolute neutrophil count, absolute lymphocyte count, absolute platelet count, urinary protein, urinary creatinine, urinary protein-creatinine ratio (PCR), serum creatinine and eGFR. Results: Among the studied patients, male were 60%, and female were 40%, mean age of 40.1 and a range of 14-30 years. The distribution of CKD stages among the patients was as follows: 36.7% in stage 1, 16% in stage 2, 14.9% in stage 3A, 9% in stage 3B, 10.1% in stage 4 and 13.3% in stage 5. Both PLR and NLR correlated positively with proteinuria, with NLR emerging as a stronger predictor of inflammation than PLR, with data showing a stage-wise increase in NLR values, particularly higher in patients in advanced CKD stages. Conclusion: NLR and PLR can be used as biomarkers for assessing inflammation and monitoring CKD severity. These biomarkers demonstrate a stage-wise increase across different CKD stages in various patients, with higher values observed in advanced stages, thus helping identify those at risk.
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spelling doaj-art-85d6d6b81a1744a08f0b1bde0a41ba7f2025-08-20T03:29:14ZengSouth Kazakhstan Medical AcademyCentral Asian Journal of Medical Hypotheses and Ethics2708-98002025-06-016211312010.47316/cajmhe.2025.6.2.04460Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic biomarkers of proteinuria and CKD severity: A cross-sectional studyFatima Khurshid0Shaikha Amjad1Muhammad Talha2Zainab Nadeem3Mahnoor Sohail4Muhammad Ahmad5Madiha Mumtaz6Forman Christian College, Lahore, PakistanHussain College of Health Sciences, Lahore, PakistanHussain College of Health Sciences, Lahore, PakistanHussain College of Health Sciences, Lahore, PakistanAmeer-ud-Din Medical College, Lahore, PakistanHussain College of Health Sciences, Lahore, PakistanSchool of biological sciences, Lahore PakistanObjectives: Chronic kidney disease (CKD) is characterized by a prolonged decline in kidney function, defined by an estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73 m² for over 3 months. Persistent, low-grade systemic inflammation is critical to CKD progression and associated with higher mortality. This study aims to evaluate the role of Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte ratio (PLR) as hematological inflammatory biomarkers across different stages of CKD to observe their trends in relation to proteinuria and assess CKD severity. Materials and Methods: This cross-sectional study was conducted at a Tertiary Care Hospital, with 188 patients who presented with CKD, between May 2024 and September 2024. Laboratory data included absolute neutrophil count, absolute lymphocyte count, absolute platelet count, urinary protein, urinary creatinine, urinary protein-creatinine ratio (PCR), serum creatinine and eGFR. Results: Among the studied patients, male were 60%, and female were 40%, mean age of 40.1 and a range of 14-30 years. The distribution of CKD stages among the patients was as follows: 36.7% in stage 1, 16% in stage 2, 14.9% in stage 3A, 9% in stage 3B, 10.1% in stage 4 and 13.3% in stage 5. Both PLR and NLR correlated positively with proteinuria, with NLR emerging as a stronger predictor of inflammation than PLR, with data showing a stage-wise increase in NLR values, particularly higher in patients in advanced CKD stages. Conclusion: NLR and PLR can be used as biomarkers for assessing inflammation and monitoring CKD severity. These biomarkers demonstrate a stage-wise increase across different CKD stages in various patients, with higher values observed in advanced stages, thus helping identify those at risk.https://cajmhe.com/index.php/journal/article/view/460chronic kidney insufficiencyneutrophil-lymphocyte ratioplatelet-lymphocyte ratioestimated glomerular filtration ratechronic inflammation
spellingShingle Fatima Khurshid
Shaikha Amjad
Muhammad Talha
Zainab Nadeem
Mahnoor Sohail
Muhammad Ahmad
Madiha Mumtaz
Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic biomarkers of proteinuria and CKD severity: A cross-sectional study
Central Asian Journal of Medical Hypotheses and Ethics
chronic kidney insufficiency
neutrophil-lymphocyte ratio
platelet-lymphocyte ratio
estimated glomerular filtration rate
chronic inflammation
title Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic biomarkers of proteinuria and CKD severity: A cross-sectional study
title_full Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic biomarkers of proteinuria and CKD severity: A cross-sectional study
title_fullStr Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic biomarkers of proteinuria and CKD severity: A cross-sectional study
title_full_unstemmed Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic biomarkers of proteinuria and CKD severity: A cross-sectional study
title_short Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic biomarkers of proteinuria and CKD severity: A cross-sectional study
title_sort neutrophil to lymphocyte and platelet to lymphocyte ratios as prognostic biomarkers of proteinuria and ckd severity a cross sectional study
topic chronic kidney insufficiency
neutrophil-lymphocyte ratio
platelet-lymphocyte ratio
estimated glomerular filtration rate
chronic inflammation
url https://cajmhe.com/index.php/journal/article/view/460
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