Relationship between the ratio of inflammatory cells in peripheral blood and microinflammation in patients with chronic kidney disease

Objective To evaluate the association of neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio (PLR)with the microinflammation status in patients with chronic kidney disease (CKD). Methods 210 CKD patients who received treatment in Department of Nephrology,Renmin Hospital of Wuhan University from August 2016 to October 2017 were recruited for this study. They were divided into three groups:50 CKD patients(at stage 3-4)before dialysis as pre-dialysis group, 90 CKD patients receiving maintenance hemodialysis (MHD)with stable clinical conditions as MHD group, and 70 CKD patients given peritoneal dialysis(PD) with stable clinical conditions as PD group. Thirty healthy individuals served as the healthy control group. Blood routine examination was done, and laboratory indicators and hs-CRP were determined. NLR and PLR were calculated. Statistical differences of laboratory indicators among the 4 groups were analyzed. The correlation among NLR,PLR and other Laboratory indicators were analyzed also. According to the hs-CRP levels, 210 CKD patients were divided into hs-CRP low level group(≤ 3 mg/L) and hs-CRP high level group(>3 mg/L). hs-CRP>3.0 mg/L suggests a high risk of cardiovascular disease. Statistical differences of laboratory indicators between the two groups were analyzed. The sensitivity and specificity of NLR and PLR to assess the risk of cardiovascular disease were calculared. Results In CKD patients,NLR and hs-CRP were significantly higher than in healthy control group(P<0.05).In MHD group and PD group,PLR were significantly higherthan in healthy control group(P<0.05). NLR and PLR were positively correlated with hs-CRP in CKD patients(P<0.05). As compared with hs-CRP low level group, age,NLR and PLR in hs-CRP high level group were significantly increased (P<0.05 for all).There was a high risk of cardiovascular disease in hs-CRP high level group. In hs-CRP low level group and hs-CRP high level group, the sensitivity and specificity of NLR were 78.8% and 53.3%, and those of PLRwere 78.8% and 41.7%, respectively. Conclusions NLR may be used as amarker of systemic microinflammation statusin patients with CKD,PLR may be used as a marker of systemic microinflammation status in dialysis patients with CKD, they can evaluation the risk of cardiovascular diseases,they are inexpensive and parameter easily found in Blood routine examination.