Neutrophil-Lymphocyte Ratio(NLR) is Significantly Decreased in Kidney Transplant Patients

Abstract

Background The neutrophil-to-lymphocyte ratio (NLR) is a novel simple biomarker of in inflammation. It has emerged as a predictor of poor prognosis in cancer and cardiovascular disease in general population. Recently, some studies have demonstrated that higher NLR in end-stage renal disease (ESRD) patients was associated with the increased risk of cardiovascular disease. However, little was known of its prognostic value in kidney transplant patients. In this preliminary study, we retrospectively analyzed NLR in kidney transplant patients. Materials and Methods Between April 2009 and December 2016, 140 kidney transplantations were performed in our institute. One hundred thirty-one kidney transplant recipients were included in this study. We retrospectively investigated NLR, CRP, and other hematologic parameters levels of that transplant patients. And these data were compared with that of dialysis patients(N=40) and healthy controls(N=30). The data on the day of transplantation and at the end of first year were analyzed. Results We included 131 recipients, 40 dialysis patients and 30 healthy control individuals in our study. Of the 131 recipients, 29 (22%) were transplanted preemptively. Of the patients, 108 were already on either hemodialysis or peritoneal dialysis therapy at the time of transplantation. Mean NLR of the control group was significantly lower than those of ESRD patient group (Control group:1.862±0.471, Recipient group: 3.659±2.087 and Dialysis group: 4.351±2.359, respectively; P <0.05). We also found the significant improvement of inflammatory state in kidney transplant patients at the end of first year evaluation (mean NLR:2.830±1.427). Between preemptive group and nonpreemptive group, there were no significant differences in the mean NLR at the end of first year. Conclusion The NLR is an easily applicable method for evaluation of inflammation. We showed the increase of NLR in all ESRD patients when compared with healthy controls and the improvement of NLR in kidney transplant recipients at the end of first year evaluation. The monitoring of NLR may possibly be a cheap, useful and independent predictor of cardiovascular disease in transplant patients.