EVALUATION OF THE RELATIONSHIP BETWEEN NEUTROPHIL TO LYMPHOCYTE RATIO AND RENAL OUTCOMES PATIENTS WITH CHRONIC RENAL DISEASE

ABSTRACT Aim: Regardless of the cause of renal disease, there is strong evidence that an acute and chronic proinflammatory condition exists in adults with chronic renal disease (CRD) and End Stage Renal Disease (ESRD) and that inflammation contributes to morbidity and mortality. In this study, we aimed to investigate whether neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are associated with poor renal outcome (ESRD + Death) in patients with CRD. Materials and Methods: 194 Turkish CRD (stage 3-5) patients who were regularly came to the nephrology outpatient clinic were enrolled to study. patients records were evaluated and groupped according to the renal status and mortality at the end of four years follow up time. Results: During the follow-up period, 15 out of 194 patients died, renal replacement treatment began to 89 patients and remaning 90 patients were still followed as non-ESRD patients. When compared the patients with ESRD and who were still followed up as non-ESRD patients there was a statistically significant difference in male gender, follow-up time, BMI, SBP, DBP, baseline eGFR, albumin, Hb, Ca, P, NLR, PLR and spot urine creatine ratio.NLR was as an independent risk factor in CRD patients for the progression of the disease and the poor renal outcome. Conclusion: In conclusion, we demonstrated that NLR is an independent predictor of ESRD and poor renal outcome in CRD patients. Therefore, NLR measurement may be useful in predicting the progression of kidney disease in CRD patients. Keywords: Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, chronic renal disease, progression OZET Amac: Bobrek hastaliginin nedenine bakilmaksizin, kronik bobrek hastaligi (KBH) ve Son Evre Bobrek Hastaligi (SDBY) olan yetiskinlerde akut ve kronik proinflamatuar bir durumun var olduguna ve inflamasyonun morbidite ve mortaliteye katkida bulunduguna dair guclu kanitlar vardir. Bu calismada, CRD hastalarinda notrofil / lenfosit oraninin (NLR) ve trombosit / lenfosit oraninin (PLR) kotu bobrek sonucu (ESRD + Olum) ile iliskili olup olmadigini arastirmayi amacladik. Gerec ve yontem: Nefroloji poliklinigine duzenli olarak basvuran 194 Turk CRD (evre 3-5) calismaya alindi. Dort yillik izlem suresi sonunda hasta kayitlari bobrek durumuna ve mortaliteye gore degerlendirildi. Bulgular: Takip suresi boyunca 194 hastadan 15'i oldu, 89 hastaya renal replasman tedavisi baslandi ve 90 hasta halen ESRD olmayan hastalar olarak takip edilmektedir. ESRD olan hastalar ESRD olmayan hastalar ile karsilastirildiginda erkek cinsiyet, takip suresi, BMI, SBP, DBP, baslangic eGFR, albumin, Hb, Ca, P, NLR, PLR ve spot idrar kreatin orani arasinda istatistiksel olarak anlamli bir fark vardi. NLR, CRD hastalarinda hastaligin ilerlemesi ve kotu bobrek sonucu icin bagimsiz bir risk faktoru olarak bulundu. Sonuc: Sonuc olarak, NLR'nin CRD hastalarinda bagimsiz bir ESRD ve kotu bobrek sonucu ongorucusu oldugunu gosterdik. Bu nedenle NLR olcumu, CRD hastalarinda bobrek hastaliginin ilerlemesini tahmin etmede yararli olabilir. Anahtar Kelimeler: Notrofil / lenfosit orani, trombosit / lenfosit orani, kronik bobrek hastaligi, progresyon