Clinical Profile of Diabetic Nephropathy and its Correlation with Neutrophil-Lymphocyte Ratio in Type 2 Diabetes Mellitus

Abstract

Objectives: Diabetic nephropathy (DN) is a microvascular complication of diabetes. It manifests clinically as albuminuria which is the precursor of end-stage renal failure. This is considered to be an inflammatory process. In recent past, it has been reported that the neutrophil-lymphocyte ratio (NLR) may be a favourable indicator of the inflammatory status. It is cost effective and easily accessible marker. The present research was undertaken to study the clinical profile of DN and to see the association between NLR and DN in patients with type 2 diabetes mellitus (DM). Material and Methods: A total of 210 patients were enrolled, of them 105 healthy individuals without diabetes were taken as controls and cases were 105 subjects with type 2 diabetes. Patients were, further, divided based on urine albumin creatinine ratio (UACR) into DM without nephropathy (UACR <30 mg/g) group and DM with nephropathy (UACR >30 mg/g) group. For intragroup comparison, DM with nephropathy group was, further, divided into microalbuminuria (UACR 30–300 mg/g) and macroalbuminuria (UACR >300 mg/g). Results: NLR was found significantly increased (P < 0.0001) in patients with DN (2.81 ± 0.51) as compared with DM without nephropathy (2.12 ± 0.64) and healthy adults (2.06 ± 0.29). However, NLR value was unable to differentiate between patients with microalbuminuria and macroalbuminuria. There was a significant correlation between NLR and DN in type 2 diabetes while there was no statistically significant difference in distribution of NLR in different stages of chronic kidney disease. Conclusion: NLR can be used as a novel biomarker of DN in patients with type 2 DM.