MO569: Assessment of Inflammation Using Neutrophil-Lymphocyte Ratio Among Non-Dialyzed Chronic Kidney Disease Patients—A Prospective Observational Study

Abstract

Abstract BACKGROUND AND AIMS Persistent low-grade inflammation is intimately linked to the pathophysiology of chronic kidney disease and contributes grossly to poor nutritional status and mortality. There is insufficient evidence on inflammation in relation to diabetic status, stages of CKD among chronic kidney disease patients before the commencement of dialysis. This study has characterized the prevalence and factors of inflammation among pre-dialysis chronic kidney disease patients at a tertiary care public teaching hospital. METHOD This longitudinal observational study adopted neutrophil–lymphocyte ratio (>3.53) to evaluate the inflammatory status among pre-dialysis chronic kidney disease patients. Glomerular filtration rate (eGFR) calculated by CKD-EPI equation from National Kidney Foundation was used as a measure of renal function. Multiple/multinomial regression analysis was also performed to determine the predictors of inflammatory status. RESULTS A total of 450 non-dialysis chronic kidney disease patients with or with diabetes were recruited during the period of study, consisting of 265 males and 185 females. Patients were aged 53.9 ± 14.2 years. According to neutrophil–lymphocyte ratio, the prevalence of inflammation among chronic kidney disease patients was found to be 91 (20.2%). The chronic kidney disease patients with diabetes 51(11.3%) were found to have higher rates of inflammation than non-diabetic chronic kidney disease patients 40 (8.9%). The adult age group 57 (12.7%) suffered more with inflammation than the elderly 34 (7.6%). Patients with severe malnutrition 42 (9.3%) were noted to have higher prevalence of inflammation followed by well-nourished 27 (6.0%) and mild/moderately malnourished population 22 (4.9%). The extent of inflammation was found to increase {CKD stage 1–2 (0.6%), CKD stage 3a-3b 34 (7.6%), CKD stage 4–5 54 (12.0%)} with decrease in renal residual function. Serum albumin, nutritional status and serum phosphorous have shown a significant association with the inflammatory status among chronic kidney disease patients. CONCLUSION The current findings demonstrate that the inflammation should be regarded as a familiar comorbid condition in chronic kidney disease. The intensity of inflammation is greater in patients with poorer renal function, comorbid diabetes and higher age. Future work needs to be aligned with respect to comprehensive understanding of inflammation mechanisms among patients with chronic kidney disease.