Neutrophil-to-lymphocyte ratio is a predictor of renal dysfunction in Japanese patients with type 2 diabetes

Abstract

BackgroundNeutrophil-to-lymphocyte ratio (NLR) has been widely evaluated as a biomarker in various medical and surgical prognoses, but its usefulness in diabetic kidney disease is not yet known. MethodsThis prospective observational study included outpatients, comprised of 184 men aged 73 ± 11 (mean ± standard deviation) years and 174 women aged 76 ± 10 years at baseline, from a rural hospital. We examined the relationship between baseline NLR calculated by analyzing the differential leukocyte counts in the complete blood count and the 2-year estimated glomerular filtration rate (eGFR) decline rate (i.e. 2-year eGFR−baseline eGFR) ∗100/baseline eGFR. Rapid eGFR decline rate was defined as a value < -25%. ResultsMultiple linear regression analysis using rapid eGFR decline rates as objective variables, adjusted for confounding factors as explanatory variables, showed that NLR (β = 0.138, p = 0.007) as well as presence of antidyslipidemic medication, hemoglobinA1c, and urinary albumin excretion stage were significantly and independently associated with a rapid eGFR decline rate. The multivariate-adjusted odds ratios (95% confidence interval) of the 2nd and 3rd tertiles of baseline NLR for rapid eGFR decline rate were 3.62 (0.70–18.7) and 8.03 (1.54–41.9), respectively. Multivariate-adjusted mean eGFR (95% confidence interval) values after 2 years categorized by tertile of baseline NLR were: 1st, 63.9 (61.8–66.1); 2nd, 60.8 (58.7–62.9); and 3rd, 58.9 (56.8–61.0). ConclusionsThese results suggest that baseline NLR might be a useful biomarker for renal function decline in outpatients with diabetes.