Correlation of the Neutrophil-to-Lymphocytes Ratio with Serum Urea and Creatinine Levels in Leptospirosis Patients

Abstract

Background: Leptospirosis is a zoonosis that is still a problem in Indonesia. The kidneys are often the target organs in leptospirosis. The outer membrane of Leptospira Sp contains antigenic components and toxins that stimulate the inflammatory process in the kidneys. The neutrophil-to-lymphocyte ratio (NLR) is used as a marker of the inflammatory process, while urea creatinine is a sign of kidney damage. Objective: To prove the correlation between NLR and serum urea and creatinine levels in leptospirosis patients. Methods: This study was carried out retrospectively on the medical records of patients with confirmed leptospirosis by Microscopic Agglutination Test (MAT) at Dr. Kariadi Semarang between January 2020 and July 2022. NLR examination was obtained by dividing the number of neutrophils by the number of lymphocytes in the leukocyte count, urea, and creatinine levels from the patient's medical record. Statistical analysis using the Spearman correlation test, with a significance level of p <0.05. Results: From 33 samples, the median NLR was 10.75 (2.19-47,5), the median urea level was 131.0 mg/dL (15–467 mg/dL) creatinine 2.0 mg/dL (0.7-11.9 mg/dL). The correlation between NLR with urea (p=0.001 and r=0.561) and creatinine (p=0.003 and r=0.501). Increased NLR, urea, and creatinine were found in leptospirosis patients. Conclusion: There is a moderate positive correlation between NLR and urea and creatinine. An increase in NLR is a sign of an inflammatory process from leptospirosis. An increase in NLR correlates with an increase in urea and creatinine