Neutrophil-Lymphocyte Ratio and C-Reactive Protein levels are increased in patients with diabetic kidney disease — ASN Events

Neutrophil-Lymphocyte Ratio and C-Reactive Protein levels are increased in patients with diabetic kidney disease (#197)

Lydia Wong 1 , George Jerums , Michele Clarke , Renata Libianto , Sara Baqar , Jas-mine Seah , Scott Baker , Felicity Pyrlis , Thuy Vu , Richard J MacIsaac , Elif I. Ekinci
  1. Austin Hospital, Fitzroy, VIC, Australia


The neutrophil-to-lymphocyte ratio (NLR) and high-sensitivity C-reactive protein (CRP) are reliable measures of systemic inflammation. We hypothesized that a higher NLR and CRP are associated with an increase in albumin excretion rate (AER) and reduced glomerular filtration rate (GFR) in diabetes.

504 patients with type 1 or type 2 diabetes attending Austin Health Diabetes Clinics were recruited in a prospective study. NLR was calculated by dividing total neutrophil count by total lymphocyte count. 

NLR values were significantly higher for patients with albuminuria (AER>20ug/min) compared to patients with normoalbuminuria (p<0.001, Fig1), as well as in patients with eGFR<60ml/min/1.73m2 compared to patients with eGFR>60ml/min/1.73 m2 (p<0.01, Fig1). CRP levels were significantly lower in patients with normoalbuminuria compared to those with albuminuria (p<0.02, Fig1), but were not related to eGFR.

Higher NLR values are independently associated with reduced eGFR and increased AER in patients with diabetic kidney disease. Higher CRP levels are only associated with increased AER, with no relationship to eGFR. Whether these findings represent cause, effect, or association, awaits the results of interventional studies.

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