The association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red blood cell distribution width, and physical function in elderly non-dialysis patients with chronic kidney disease

Abstract Background The physical function of elderly patients with chronic kidney disease (CKD) is influenced by chronic inflammatory status. This study aimed to investigate the association between systemic inflammatory markers—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR)...

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Main Authors: Jing Chang, Zhuoran Qi, Xiukun Yin, Xiangyang Fang, Qianmei Sun
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-06277-x
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author Jing Chang
Zhuoran Qi
Xiukun Yin
Xiangyang Fang
Qianmei Sun
author_facet Jing Chang
Zhuoran Qi
Xiukun Yin
Xiangyang Fang
Qianmei Sun
author_sort Jing Chang
collection DOAJ
description Abstract Background The physical function of elderly patients with chronic kidney disease (CKD) is influenced by chronic inflammatory status. This study aimed to investigate the association between systemic inflammatory markers—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW)—and physical function in elderly non-dialysis patients with CKD. Methods Data were collected from CKD patients aged ≥ 60 years. Physical function was evaluated using the Barthel Index (BI) of the activities of daily living (ADL) scale. Participants were stratified into two groups: BI ≥ 60 and BI < 60. Differences in NLR, PLR, and RDW levels between the two groups were compared. Subsequently, multivariable logistic regression analysis was performed to assess the association of these three indicators (as continuous or categorical variables) with physical function. Results A total of 1005 eligible patients were included, comprising 880 patients in the BI ≥ 60 group and 125 patients in the BI < 60 group. NLR (3.71 ± 1.78 vs. 2.82 ± 1.58, P < 0.001), PLR (158.50 ± 66.98 vs. 138.84 ± 63.48, P = 0.001), and RDW (14.01 ± 1.47 vs. 13.38 ± 1.30, P < 0.001) were significantly higher in the BI < 60 group compared to the BI ≥ 60 group. Multivariable regression analysis demonstrated that elevated NLR (OR = 1.278, 95% CI: 1.138–1.435, P < 0.001) and PLR (OR = 1.004, 95% CI: 1.001–1.006, P = 0.014) were independently associated with physical function dependence in elderly non-dialysis CKD patients. Conclusion Higher levels of NLR, PLR, and RDW were observed in elderly non-dialysis CKD patients with poor physical function. Elevated NLR and PLR were independently associated with physical function dependence.
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spelling doaj-art-be5ed32efc124107aae2ecc72cb2b9922025-08-20T03:06:04ZengBMCBMC Geriatrics1471-23182025-08-0125111010.1186/s12877-025-06277-xThe association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red blood cell distribution width, and physical function in elderly non-dialysis patients with chronic kidney diseaseJing Chang0Zhuoran Qi1Xiukun Yin2Xiangyang Fang3Qianmei Sun4Department of Internal Medicine, Beijing Chao-yang Hospital, Capital Medical UniversityDepartment of Nephrology, Civil Aviation General HospitalDepartment of Nephrology, Beijing Chao-yang Hospital, Capital Medical UniversityDepartment of Internal Medicine, Beijing Chao-yang Hospital, Capital Medical UniversityDepartment of Nephrology, Beijing Chao-yang Hospital, Capital Medical UniversityAbstract Background The physical function of elderly patients with chronic kidney disease (CKD) is influenced by chronic inflammatory status. This study aimed to investigate the association between systemic inflammatory markers—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW)—and physical function in elderly non-dialysis patients with CKD. Methods Data were collected from CKD patients aged ≥ 60 years. Physical function was evaluated using the Barthel Index (BI) of the activities of daily living (ADL) scale. Participants were stratified into two groups: BI ≥ 60 and BI < 60. Differences in NLR, PLR, and RDW levels between the two groups were compared. Subsequently, multivariable logistic regression analysis was performed to assess the association of these three indicators (as continuous or categorical variables) with physical function. Results A total of 1005 eligible patients were included, comprising 880 patients in the BI ≥ 60 group and 125 patients in the BI < 60 group. NLR (3.71 ± 1.78 vs. 2.82 ± 1.58, P < 0.001), PLR (158.50 ± 66.98 vs. 138.84 ± 63.48, P = 0.001), and RDW (14.01 ± 1.47 vs. 13.38 ± 1.30, P < 0.001) were significantly higher in the BI < 60 group compared to the BI ≥ 60 group. Multivariable regression analysis demonstrated that elevated NLR (OR = 1.278, 95% CI: 1.138–1.435, P < 0.001) and PLR (OR = 1.004, 95% CI: 1.001–1.006, P = 0.014) were independently associated with physical function dependence in elderly non-dialysis CKD patients. Conclusion Higher levels of NLR, PLR, and RDW were observed in elderly non-dialysis CKD patients with poor physical function. Elevated NLR and PLR were independently associated with physical function dependence.https://doi.org/10.1186/s12877-025-06277-xChronic kidney diseaseNeutrophil-to-Lymphocyte ratioPlatelet-to-Lymphocyte ratioRed blood cell distribution widthPhysical function
spellingShingle Jing Chang
Zhuoran Qi
Xiukun Yin
Xiangyang Fang
Qianmei Sun
The association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red blood cell distribution width, and physical function in elderly non-dialysis patients with chronic kidney disease
BMC Geriatrics
Chronic kidney disease
Neutrophil-to-Lymphocyte ratio
Platelet-to-Lymphocyte ratio
Red blood cell distribution width
Physical function
title The association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red blood cell distribution width, and physical function in elderly non-dialysis patients with chronic kidney disease
title_full The association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red blood cell distribution width, and physical function in elderly non-dialysis patients with chronic kidney disease
title_fullStr The association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red blood cell distribution width, and physical function in elderly non-dialysis patients with chronic kidney disease
title_full_unstemmed The association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red blood cell distribution width, and physical function in elderly non-dialysis patients with chronic kidney disease
title_short The association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red blood cell distribution width, and physical function in elderly non-dialysis patients with chronic kidney disease
title_sort association between neutrophil to lymphocyte ratio platelet to lymphocyte ratio red blood cell distribution width and physical function in elderly non dialysis patients with chronic kidney disease
topic Chronic kidney disease
Neutrophil-to-Lymphocyte ratio
Platelet-to-Lymphocyte ratio
Red blood cell distribution width
Physical function
url https://doi.org/10.1186/s12877-025-06277-x
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