Relação neutrófilos/linfócitos e relação plaquetas/linfóticos como marcadores de inflamação em pacientes renais crônicos não dialíticos

Abstract

Introduction: Neutrophil-Lymphocyte Relationship (NLR) and Platelet-Lymphocyte Relationship (PLR) are surrogate marker of inflammation and has been widely studied in malignancies, hypertension, heart and vascular diseases. This study aimed to evaluate the better sensitivity and specificity of NLR and PLR as markers of inflammation in patients with Chronic Kidney Disease (CKD) under conservative treatment. Methods: To implement this analysis we carried out a prospective cross-sectional study involving 85 individuals with CKD in different stages of CKD accompanied at the Kidney Diseases Prevention Center of the University Hospital of the Federal University of Maranhão between September 2016 and August 2017. The study included patients diagnosed with non-dialysis CKD, conservative treatment, aged 18 years and over. Blood samples collected for the C-Reactive Protein. They were divided into two groups: presence and absence of inflammation based on CRPus value (<0.5mg/dL). The calculations for NLR and PLR were performed from the absolute number of neutrophils, lymphocytes and platelets, and were compared between them and with CRPus (gold standard method). Results: A total of 85 subjects were included in the study, of which 60% were over 60 years old and 55.29% were female. The median NLR was 2.11 (1.41 - 3.36) and the PLR was 121.95 (94.72 - 157.45). RNL and RPL values were statistically significant between patients with and without inflammation (p = 0.045; p = 0.004, respectively). However, in relation to the gold standard method, only the LPL showed a significant positive correlation with CRPus (p = 0.015). The best cut off point for NLR to detect inflammation was 1.98 with 76.19% sensitivity and 48.44% specificity, and the best cutoff point for PLR was 116.07, with 85.71% sensitivity and 51.56% specificity. The area under the PLR curve was better than the NLR (0.71 vs 0.64) for this population. Conclusion: PLR had a better correlation with CRPus and was better sensitivity and specificity to detect inflammation in chronic renal patients undergoing conservative treatment.