Abstract
PurposePlatelet-to-lymphocyte ratio (PLR) was established showing the poor prognosis in several diseases, such as malignancies and cardiovascular diseases. But limited study has been conducted about the prognostic value of PLR on the long-term renal survival of patients with Immunoglobulin A nephropathy (IgAN).MethodsWe performed an observational cohort study enrolling patients with biopsy-proven IgAN recorded from November 2011 to March 2016. The definition of composite endpoint was eGFR decrease by 50%, eGFR < 15 mL/min/1.73 m2, initiation of dialysis, or renal transplantation. Patients were categorized by the magnitude of PLR tertiles into three groups. The Kaplan–Meier curves and multivariate Cox models were performed to determine the association of PLR with the renal survival of IgAN patients.Results330 patients with a median age of 34.0 years were followed for a median of 47.4 months, and 27 patients (8.2%) had reached the composite endpoints. There were no differences among the three groups (PLR < 106, 106 ≤ PLR ≤ 137, and PLR > 137) in demographic characteristics, mean arterial pressure (MAP), proteinuria, and estimated glomerular filtration rate (eGFR) at baseline. The Kaplan–Meier curves showed that the PLR > 137 group was significantly more likely to poor renal outcomes than the other two groups. Using univariate and multivariate cox regression analyses, we found that PLR > 137 was an independent prognostic factor for poor renal survival in patients with IgAN. Subgroup analysis revealed that the PLR remained the prognostic value for female patients or patients with eGFR less than 60 mL/min/1.73 m2.ConclusionsOur results underscored that baseline PLR was an independent prognostic factor for poor renal survival in patients with IgAN, especially for female patients or those patients with baseline eGFR less than 60 mL/min/1.73 m2.
Highlights
Materials and methodsImmunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulonephritis worldwide [1]
Clinical and laboratory data were collected from all patients at the time of renal biopsy, including age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), white blood cell count (WBC), platelet count, lymphocyte count, hemoglobin, serum albumin, serum creatinine (Scr), uric acid (UA), estimated glomerular filtration rate, and proteinuria quantity
Patients were categorized by the magnitude of Platelet-to-lymphocyte ratio (PLR) tertiles into three groups: group 1 with PLR < 106 (n = 111), group 2 with 106 ≤ PLR ≤ 137 (n = 109) while group 3 with PLR > 137 (n = 110) (Table 1)
Summary
Materials and methodsImmunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulonephritis worldwide [1]. The number of patients with IgAN accounts for 58.2% of glomerulonephritis in China [2]. Studies have shown that 15% to 40% of patients with IgAN develop the end-stage renal disease (ESRD) by 10 to 20 years after diagnosis [3, 4]. As one of the main reasons to increase the social burden, it is still challenging to precisely predict the outcomes of IgAN patients [5, 6]. Several clinical indicators such as renal function and proteinuria at biopsy are demonstrated to be associated with the renal outcome of IgAN [7,8,9]. We need to find new risk factors of IgAN to timely prevent the disease from deterioration
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