000156557 001__ 156557
000156557 005__ 20251017144557.0
000156557 0247_ $$2doi$$a10.1093/ndt/gfaa142.P0594
000156557 0248_ $$2sideral$$a119752
000156557 037__ $$aART-2020-119752
000156557 041__ $$aeng
000156557 100__ $$aPeña Porta, Jose Maria$$uUniversidad de Zaragoza
000156557 245__ $$aUsefulness of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in the community-adquired acute kidney injury
000156557 260__ $$c2020
000156557 5060_ $$aAccess copy available to the general public$$fUnrestricted
000156557 5203_ $$aP0594
Introduction and Aims The neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios have been identified as markers of inflammation and endothelial dysfunction in recent literature. Both are easily measured, reproducible and inexpensive, therefore cost-effective. To date, its usefulness as prognostic markers in community-acquired acute kidney injury (CA-AKI) has not been evaluated. The aim of this study was to analyze the usefulness of the NLR and PLR in terms of morbidity and mortality in community-acquired acute kidney injury.
Method We established a cohort of 308 patients with community-acquired acute kidney injury (CA-AKI) admitted to the Nephrology service of a third level hospital from January 2010 to February 2015. NLR and PLR ratios were obtained with the levels of the first analysis performed at admission.
Results We studied 308 patients with CA-AKI, 180 were men (58, 4 %), mean age was 73.22 (±13, 95). The mean length of stay was 12, 25 days (±11, 69). The etiology of CA-AKI was divided in prerenal 214 cases (69.5%); renal 71 cases (23.1%); obstructive 23 cases (7, 5%). AKI KDIGO stages were stage I, 45 cases (14.6%); stage II, 34 cases (11%); stage III 229 cases (74.4%). Previous chronic kidney disease (CKD) was detected in 212 cases (68.8%). A total of 54 patients (17, 15%) required hemodialysis and 38 patients died during admission (12.3%). Mean NLR was 9.14 ± 8, 47 (95% IC 8, 2-10, 1). Mean PLR was 236, 99 ± 228, 41 (95% IC 211, 38-262, 6). NLR according to etiology was: prerenal 8, 55±6, 8; renal 9, 37±9, 8; obstructive 13, 99±14, 82 (significant differences of the latter group compared to the prerenal group). PLR according to etiology: prerenal 228, 31±216, 34; renal 236, 15±233, 77; obstructive 320, 37±304, 89 (non-significant differences). Within the group of prerenal origin, 79 cases were complicated by the development of acute tubular necrosis (ATN). These cases presented a higher NLR (NLR of ATN 10, 7±10, 28 vs NLR of pure prerenal 7, 8±5, 6; p=0, 026). There were no significant differences between the PLR of the pure prerenal group and the group with ATN (225, 95±262, 54 vs 285, 78±278, 61). The NLR showed a significant correlation with the peak creatinine (r= 0, 186; p = 0, 001) and with the serum albumin (r= -0, 237; p < 0, 001). The PLR also showed correlation with the peak creatinine (r= 0, 134, p = 0, 018) and the serum albumin (r = 0, 165, p= 0, 07).The NLR, but not the PLR, was associated with the length of hospital stay (multiple linear regression analysis). Through a multivariate binary logistic regression analysis, the variables that were independently associated with mortality during admission were the Liaño individual severity index and the NLR (OR 1, 060; IC 95 % 1.014 – 1, 108). The variables that were ruled out by the model were sex, age, Charlson comorbidity index, peak creatinine, serum albumin, chronic kidney disease, etiology of AKI (prerenal vs. non prenal), potassium, KDIGO stage of AKI, need of hemodialysis and PLR. The best cut-off point of the NLR to predict mortality was 6, 68 (AUC 0, 584; sensitivity 0.60; specificity 0.58; Youden index 0.178)
Conclusion In our cohort of patients affected by CA-AKI, the NLR was associated with the morbidity and the mortality during admission. More studies are need to confirm this finding, but the easiness of obtaining it and its economic cost make it cost-effective, giving the NLR a leading role in assessing the risk of CA-AKI.
000156557 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000156557 590__ $$a5.992$$b2020
000156557 591__ $$aUROLOGY & NEPHROLOGY$$b13 / 89 = 0.146$$c2020$$dQ1$$eT1
000156557 591__ $$aTRANSPLANTATION$$b3 / 25 = 0.12$$c2020$$dQ1$$eT1
000156557 592__ $$a1.653$$b2020
000156557 593__ $$aMedicine (miscellaneous)$$c2020$$dQ1
000156557 593__ $$aTransplantation$$c2020$$dQ1
000156557 593__ $$aNephrology$$c2020$$dQ1
000156557 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000156557 700__ $$aCastellano Calvo, Almudena
000156557 700__ $$aCoscojuela Otto, Ana
000156557 700__ $$aTomás Latorre, Alejandro
000156557 700__ $$aFerreras Gascó, José Antonio
000156557 700__ $$0(orcid)0000-0002-3668-282X$$aMartín Azara, Pilar$$uUniversidad de Zaragoza
000156557 700__ $$aAlvarez Lipe, Rafael
000156557 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000156557 773__ $$g35, Suppl. 3 (2020), 914$$pNephrol. dial. transplant.$$tNephrology Dialysis Transplantation$$x0931-0509
000156557 8564_ $$s103581$$uhttps://zaguan.unizar.es/record/156557/files/texto_completo.pdf$$yVersión publicada
000156557 8564_ $$s1620091$$uhttps://zaguan.unizar.es/record/156557/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
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000156557 951__ $$a2025-10-17-14:13:34
000156557 980__ $$aARTICLE