scholarly journals Neutrophil Lymphocyte Ratio and C-Reactive Protein in Nondialysis Chronic Kidney Disease

2021 ◽  
Vol 1 (1) ◽  
pp. 112-119
Author(s):  
Acang Nuzirwan ◽  
Budiman. S ◽  
Sussylawati. K ◽  
Vidia. T

Background: Chronic kidney disease (CKD) occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months. Inflammatory markers such as C-reactive protein (CRP), Interleukine are widely used in CKD. However, those traditional biomarkers have their limitations because of its measurement is costly or inaccessible. Recently, the Neutrophil-to-lymphocyte ratio (NLR) was reported to be associated with inflammation in End-stage renal disease (ESRD). Its measurement is simpler and cheaper4.5. The aim of the present study was to determine whether NLR is associated with CRP in CKD patients. Methods: This cross-sectional and observational analytic study was conducted 12 consecutive Pre Hemodialysis patients ESRD between Mei 2021 and Augustus 2021. Subjects were divided into two groups according to the results of the examination of the CRP and NLR levels. Then analyzed whether there is have a correlation. Results: The composite endpoint was observed in 12 patients with ESRD; it was found that both of the values of NLR and CRP were equally increased in ESRD patients, although they were not statistically significant. Conclusion: The present study demonstrated that a high NLR in ESDR and suggesting that NLR may be a useful marker for the prediction of infection in patients with CKD.

2020 ◽  
Vol 66 (8) ◽  
pp. 1100-1107
Author(s):  
Sibel Gökçay Bek ◽  
Berna Üstüner ◽  
Necmi Eren ◽  
Zeynep Sentürk ◽  
Betül Kalender Gönüllü

SUMMARY BACKGROUND Hepcidin is an important regulator of iron homeostasis. OBJECTIVES This cross-sectional study was conducted to evaluate the association between hepcidin and components of metabolic syndrome in patients with chronic kidney disease (CKD). DESIGN AND SETTING 103 CKD patients and 59 healthy volunteers were included in the study from the University Hospital. METHODS Serum hepcidin levels were measured by enyzme-linked immunosorbent assay (ELISA) test. As for the study parameters, age, sex, body mass index, renal diseases, serum biochemistry, complete blood count, iron and total iron-binding capacity, ferritin, high-sensitive C-reactive protein (hsCRP), C- reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated. RESULTS The mean age of the patients was 58.63 ± 11.8 years. Hepcidin level was significantly associated with hypertension and higher uric acid levels (P < 0.05). There was a positive correlation between hepcidin and urea, uric acid, creatinine, ferritin, CRP, ESR, phosphorus, triglyceride, low-density lipoprotein (LDL), proteinuria and albuminuria in 24-hour urine collection. A negative correlation was found between hepcidin and estimated glomerular filtration rate (eGFR), hemoglobin, hematocrit, calcium, 25 OH vitamin D, pH, and bicarbonate levels. CONCLUSION Hepcidin, a well-known hormone regulator of iron metabolism, may play an important role in the pathogenesis of metabolic syndrome in patients with CKD, and further studies might delineate in-depth its potential as a promising early marker in these patients.


2020 ◽  
Vol 48 (6) ◽  
pp. 030006052091807
Author(s):  
Zeki Kemeç ◽  
Mustafa Demir ◽  
Ali Gürel ◽  
Fadime Demir ◽  
Selçuk Akın ◽  
...  

Objectives Platelet (PLT) indices are predictive in many diseases and conditions. The relationships of these indices with proteinuria and progression of renal disease are not well known. This study aimed to assess PLT indices in patients with primary glomerular nephrotic range proteinuria (PGNRP), with and without chronic kidney disease (CKD), and to compare these indices with those of healthy individuals (His). Methods This cross-sectional study was performed from January 2015 to May 2015. HIs (n = 57) and patients with PGNRP (n = 41) were enrolled. PLT indices and blood biochemistry parameters were compared between HIs and patients with PGNRP, as well as between subgroups of patients with PGNRP who had CKD (n = 23) and those who did not have CKD (n = 18). Results There were no statistically significant differences in any PLT indices (i.e., platelet number, mean platelet volume, plateletcrit, and platelet distribution width) between HIs and patients with PGNRP, or between the subgroups of patients with PGNRP. However, patients with PGNRP who had CKD exhibited higher median C-reactive protein and mean albumin levels, compared with patients who did not have CKD. Conclusions Pathological processes in proteinuria and CKD are not associated with PLT indices.


PPAR Research ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Asahi Hishida ◽  
Kenji Wakai ◽  
Mariko Naito ◽  
Takashi Tamura ◽  
Sayo Kawai ◽  
...  

Chronic kidney disease (CKD) is well known as a strong risk factor for both end stage renal disease and cardiovascular disease. To clarify the association of polymorphisms in thePPARgenes (PPARD,PPARG, andPPARGC1A) with the risk of CKD in Japanese, we examined this association among the Japanese subjects using the cross-sectional data of J-MICC (Japan Multi-Institutional Collaborative Cohort) Study. The subjects for this analysis were 3,285 men and women, aged 35–69 years, selected from J-MICC Study participants; genotyping was conducted by multiplex polymerase chain reaction-based Invader assay. The prevalence of CKD was determined for CKD stages 3–5 (defined as eGFR < 60 ml/min/1.73 m2). Participants with CKD accounted for 17.3% of the study population. When those withPPARDT-842CT/Twere defined as reference, those withPPARDT-842CT/CandC/Cdemonstrated the OR for CKD of 1.26 (95%CI 1.04–1.53) and 1.31 (95%CI 0.83–2.06), respectively. There were no significant associations between the polymorphisms in otherPPARgenes and the risk of CKD. The present study found a significantly increased risk of CKD in those with theCallele ofPPARDT-842C, which may suggest the possibility of personalized risk estimation of this life-limiting disease in the near future.


2020 ◽  
Author(s):  
Hung-Lung Lin ◽  
Ming-Yen Lin ◽  
Cheng-Hsun Tasi ◽  
Yi-Hsiu Wang ◽  
Chung-Jen Chen ◽  
...  

Abstract Background Harmonizing formulas have been demonstrated to be associated with reduced risk of end-stage renal disease in patients with chronic kidney disease (CKD). However, the target population and indications of harmonizing formulas in CKD remain unknown. Methods We conducted a population-based cross-sectional study to explore factors associated with harmonizing formulas prescription. Patients who had been prescribed harmonizing formulas after CKD diagnosis were defined as the using harmonizing formulas group. Disease diagnoses for harmonizing formula prescriptions and patient characteristics related to the prescriptions were collected. Results In total, 24,971 patients were enrolled in this analysis, and 5,237 (21%) patients were prescribed harmonizing formulas after CKD diagnosis. The three most frequent systematic diseases and related health problems for which harmonizing formula prescriptions were issued in CKD were symptoms, signs, and ill-defined conditions (24.5%), diseases of the digestive system, (20.67%), and diseases of the musculoskeletal system (12.9%). Higher likelihoods of harmonizing formula prescriptions were associated with young age (adjusted odds ratio: 0.98, 95% confidence interval: 0.97–0.98), female sex (1.79, 1.68–1.91), no diabetes (1.20, 1.06–1.35), no hypertension (1.38, 1.26–1.50), no cerebrovascular disease (1.34, 1.14–1.56), less disease severity (0.86, 0.83–0.89), using nonsteroidal anti-inflammatory drugs (NSAIDs) (1.65, 1.54–1.78), and using analgesic drugs other than NSAIDs (1.46, 1.35–1.59). Conclusions Harmonizing formulas are commonly used for treating symptoms of the digestive and musculoskeletal systems in CKD cases. Further research on harmonizing formula effectiveness with regard to particular characteristics of CKD patients is warranted.


2020 ◽  
Vol 8 (1) ◽  
pp. 56
Author(s):  
Eva Chris Veronica Gultom ◽  
I Made Kariasa ◽  
Masfuri Masfuri

<p><em>End Stage Renal Disease is the final stage of the Chronic Kidney Disease (CKD) with a Glomerular Filtration Rate (GFR) value of less than 15 ml / min / 1.73m². End Stage Renal Disease can be treated with hemodialysis therapy </em>(<em>National Kidney Foundation</em>, <em>2015</em>; <em>Thomas, 2014</em>).<em> The hemodialysis provides fluid resctrictions for patients who undergo. There are many factors that make fluid restrictions adherence difficult to do. (Chironda&amp;Bhengu, 2015). The biggest and dominant factor is psychological factor, which is self compassion. </em><em>Self compassion is the attitude of giving compassion to oursel</em><em>ves</em><em>, so that when a patient undergoing hemodialysis in difficult conditions is able to assume the situation is the same as other people, and does not punish themselves and have motivation in undergoing a therapeutic regimen.</em><em> </em><em>The purpose of this study was to identify </em><em>factors</em><em> </em><em>that have corelation to </em><em>fluid adherence in end stage renal disease patients undergoing hemodialysis. This study used a cross sectional method, with 89 end stage renal disease patients who underwent hemodialysis three times a week</em><em> </em><em>and who were selected using a purposive sampling technique. The results showed that the majority of patients had high self compassion (69.7%). The corelation of self compassion with fluid adherence was not significant (p=0,076), other factors affecting fluid adherence were age (p=0.033), gender (p= 0,937), marital status (p = 0.473), working status ( p = 0,885), level of education (p= 0,126), length of undergoing hemodialysis (p = 0,425), and social support (p =0,206) The results of multivariate analysis showed that the most dominant facto</em><em>r</em><em>s related to fluid restriction adherence was age. This research is expected to be a reference for nurses in developing nursing studies in end stage renal disease patients undergoing hemodialysis</em><em></em></p><p><strong>BAHASA INDONESIA ABSTRAK: </strong>Gagal ginjal terminal merupakan tahap akhir dari kondisi <em>Chronic Kidney Disease</em> (CKD) dengan nilai <em>Glomerulus Filtrasi Rate</em> (GFR) kurang dari 15 ml/menit/1,73m². Gagal ginjal terminal dapat ditangani dengan terapi hemodialisis. Adanya hemodialisis ini memberikan pembatasan cairan pada pasien yang menjalaninya. Kepatuhan pembatasan cairan pada sebagian pasien sulit untuk dilakukan dengan alasan banyak faktor, yakni usia, jenis kelamin, tingkat pendidikan, status bekerja, lama menjalani hemodialisis, status menikah, dan dukungan sosial. Faktor yang terbesar dan dominan adalah faktor psikologis, yakni <em>self compassion.</em> <em>Self compassion</em> merupakan sikap memberikan belas kasih kepada diri sendiri, sehingga ketika seorang pasien yang menjalani hemodialisis dalam kondisi sulit mampu menganggap situasinya adalah sama dengan orang lain, dan tidak menghukum diri sendiri serta memiliki motivasi dalam menjalani regimen terapi. Tujuan penelitian ini adalah untuk mengidentifikasi faktor-faktor yang berhubungan dengan kepatuhan pembatasan cairan pasien gagal ginjal terminal yang menjalani hemodialisis. Penelitian ini menggunakan metode <em>cross sectional, </em>sebanyak 89 pasien pasien gagal ginjal terminal yang menjalani hemodialisis dalam tiga kali seminggu yang dipilih menggunakan teknik <em>purposive sampling. </em>Hasil penelitian menunjukkan bahwa mayoritas pasien memiliki <em>self compassion</em> tinggi (69,7%). Hubungan <em>self compassion</em> dengan kepatuhan pembatasan cairan tidak signifikan (p=0,076), faktor lain yang mempengaruhi kepatuhan pembatasan cairan adalah adalah usia (p=0,033), jenis kelamin (p=0,937), status menikah (p=0,473), status bekerja<em> </em>(p=0,885), tingkat pendidikan (p=0,126), lama menjalani hemodialisis (p=0,425), dan dukungan sosial (p=0,206). Hasil analisis multivariat menunjukkan faktor yang paling dominan berhubungan dengan kepatuhan pembatasan cairan adalah usia. Penelitian ini diharapkan dapat menjadikan acuan bagi perawat dalam mengembangkan pengkajian keperawatan pada pasien gagal ginjal terminal yang menjalani hemodialisis.</p>


2020 ◽  
Vol 3 (2) ◽  
pp. 73-79
Author(s):  
Shanti Khadka ◽  
Rita Adhikari ◽  
Tarun Paudel

Background: Chronic Kidney Disease (CKD) is a progressive irreversible loss of renal function over a period of months or years. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintains life. Hemodialysis is used for patients who require short term dialysis (days to weeks) and for patients with advanced CKD and End Stage renal Disease (ESRD) who require long term or permanent renal replacement therapy. Hemodialysis significantly and adversely affects the lives of patients, both physically and psychologically. Depression is the most common psychological condition among patients with ESRD. Depression in dialysis patients not only effect mortality, but increased rate of hospitalizations and dialysis withdrawal is also very common. Methods: A descriptive cross sectional research design was carried out to identify the depression level of chronic kidney disease patients receiving Hemodialysis in Western Regional Hospital, Pokhara using Beck Depression Inventory among forty six patients. Results: The study findings revealed that majority of the patients (84.8%) has various degree of depression i.e. mild (21.7%), moderate (30.8%) and severe (32.6%). Only fifteen percent of patient has no depression. There was no statistical association between the level of depression and socio-demographic variables. It can be concluded that the prevalence of depression is high among patients receiving Hemodialysis. Conclusion: The prevalence of depression is high among patients receiving Hemodialysis. It is effective to provide mental health services to the CKD patients receiving Hemodialysis which help them better psychologically adaptation to their disease and improve their quality of life.  


2020 ◽  
Vol 8 (3) ◽  
pp. 161
Author(s):  
Edward Muliawan Putera ◽  
Widodo Widodo ◽  
Nunuk Mardiana

Complications such as anemia and its clinical consequences arise as chronic kidney diseases progress,. One renal anemia pathophysiology is a disruption of iron metabolism, regulated by the main iron exporter hormone, hepcidin. Chronic kidney disease patients were constantly in an inflammatory state, represented by an increased in C-reactive protein. This inflammatory state would facilitate the liver to secrete hepcidin, which would subsequently follow a decrease of iron circulation, thus resulting in functional iron deficiency. Both acute phase reactants which used thoroughly as markers in tropical and infectious diseases, had their own roles in chronic kidney disease. The correlation of c-reactive protein and hepcidin in chronic kidney disease patients was still controversial. To analyse the relationship between c-reactive protein and hepcidin in non-dialysis chronic kidney disease patients. We conducted an observational cross-sectional study with 40 non-dialysis chronic kidney disease patients who met the inclusion and exclusion criteria. Patients were enrolled with consecutive sampling and were examined for serum c-reactive protein and hepcidin levels.A total of forty subjects (67.5% male with mean age of 50.23 ± 1.04 years) were eligible for enrolment in this study. The most comorbid factor was hypertension (62.5%). The common stage for chronic kidney disease was stage 3 (40%). The mean hemoglobin value was 10.74 ± 0.36 g/dL, mean blood urea nitrogen was 39.98 ± 29.59 mg/dL, and serum creatinine of 4.12 ± 3.39 mg/dL. Mean serum c-reactive protein levels were 3.52 ± 5.13 mg/l. Mean hepcidin level were 94,03 ± 95,39 ng/ml. Serum C-reactive protein levels correlated positively (r=0.487) and significantly (p-value=0.001) with serum hepcidin value. C-reactive protein and hepcidin was significantly correlated in non-dialysis chronic kidney disease patients. 


2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Benny Hartono ◽  
Victor S. Pontoh ◽  
Marselus A. Merung

Abstract: Breast carcinoma is a type of carcinoma that has sufficiently high prevalence and can occur in men and women, with a much higher prevalence in women. In addition to the high number of cases, more than 70% of patients with breast carcinoma was found at an advanced stage. There are several studies measuring markers of inflammation and the levels of albumin in the search for an independent prognostic association in various carcinomas. The ratio of neutrophils to lymphocytes, ratio of platelets to lymphocyte, C-reactive protein, and albumin are predictors in analyzing the changes that occur before and after treatment (chemotherapy and/or surgery) in patients with breast carcinoma. This was an interventional analytical study with a cross-sectional design, conducted in Prof. Dr. R. D. Kandou Hospital Manado during the period of May 2014 to April 2015. The results showed that there were 43 females with breast carcinoma with an average age of 52.16 years. The state dof carcinoma were as follows: stage IIIA 5 patients (11.6%), IIIB 25 patients (58.1%), IIIC 11 patients (25.6%), and stage IV 2 patients (4.7%). Modality of chemotherapy plus surgery was performed on 40 patients (93%), chemotherapy only on 2 patients (4.7 %), and surgery only on 1 patient (2.3%). Among the treated patients there were significant declines in the value of neutrophils, platelets, C-reactive protein, neutrophil lymphocyte ratio, and platelet lymphocyte ratio, moreover, there were significant inclines in lymphocytes and albumin. Conclusion: Modality of chemotherapy and/or surgery in patients with breast carcinoma significantly affected the haemopoetic process (declines of neutrophil and platelet counts, NLR and TLR values), declined CRP levels, but inclined lymphocyte count as well as albumin levels when compared before and after treatment.Keywords: breast carcinoma, C-reactive protein, albumin, neutrophil lymphocyte ratio, thrombocyte lymphocyte ratioAbstrak: Karsinoma payudara (KPD) merupakan salah satu jenis karsinoma yang memiliki prevalensi cukup tinggi dan dapat terjadi pada pria maupun wanita, dengan prevalensi yang jauh lebih tinggi pada wanita. Selain jumlah kasus yang tinggi, lebih dari 70% penderita KPD ditemukan pada stadium lanjut. Terdapat beberapa penelitian mengukur petanda peradangan dan kadar albumin dalam mencari kaitan prognostik independen pada berbagai karsinoma. Rasio neutrofil limfosit, rasio trombosit limfosit, protein reaktif C, dan albumin menjadi prediktor dalam menganalisis perubahan yang terjadi sebelum dan setelah terapi (kemoterapi dan/atau operasi) pada pasien KPD. Penelitian ini merupakan penelitian intervensional analitik dengan desain potong lintang, yang dilakukan di RSUP Prof. Dr. R. D. Kandou Manado selama periode Mei 2014 - April 2015. Hasil penelitian mendapatkan 43 pasien KPD yangdirawat dengan usia rata-rata 52,16 tahun. Keadaan karsinoma stadium IIIA pada 5 pasien (11,6%), IIIB 25 pasien (58,1%), IIIC 11 pasien (25,6%), dan stadium IV 2 pasien (4,7%). Pemberian modalitas kemoterapi dan operasi pada 40 pasien (93%), hanya kemoterapi 2 pasien (4,7%), dan hanya operasi 1 pasien (2,3%). Terjadi penurunan bermakna pada nilai hitung neutrofil dan trombosit, protein reaktif C, rasio neutrofil limfosit dan rasio trombosit limfosit pada pasien yang diterapi. Selain itu terjadi peningkatan bermakna pada nilai hitung limfosit dan albumin. Simpulan Tindakan yang diberikan baik kemoterapi dan/atau operasi pada pasien karsinoma payudara memengaruhi proses hemopoetik (penurunan hitung neutrofil, trombosit, nilai NLR, nilai TLR) dan penurunan kadar CRP, serta peningkatan limfosit dan kadar albumin saat dibandingkan sebelum dan setelah diberikan perlakuan.Kata kunci: karsinoma payudara, protein reaktif C, albumin, rasio neutrofil limfosit, rasio trombosit limfosit


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