High Neutrophil-To-Lymphocyte Ratio Is an Independent Risk Factor for End Stage Renal Diseases in IgA Nephropathy

BackgroundComplex factors are involved in the development and progression of immunoglobulin A nephropathy (IgAN), a common primary glomerulonephritis worldwide. Autoimmunity and inflammation have been considered to be the basic mechanisms; however, the exact pathogenesis remains unclear. As a novel marker of inflammation, the neutrophil-to-lymphocyte ratio (NLR) has been studied in various diseases. Whether the NLR can predict the renal outcome of patients with IgAN remains unclear. We evaluated the relationships between the NLR and renal function, pathologic lesions, renal progression, and prognosis in patients with IgAN.MethodsThis retrospective study involved 966 patients with biopsy-proven IgAN. They were divided into two groups based on the cut-off value of the NLR: the high group (NLR ≥ 2.67, n = 384) and the low group (NLR < 2.67, n = 582). The endpoint was end-stage renal disease [estimated glomerular filtration rate (eGFR) of <15 mL/min/1.73 m2 or performance of renal replacement therapy]. A correlation test was conducted to explore the relationship between the NLR and other important parameters (eGFR, serum creatinine, proteinuria, hypertension and renal pathologic lesions). The predictive value was determined by the area under the receiver operating characteristics curve (AUROC). Kaplan–Meier and Cox proportional hazards analyses were performed to evaluate renal progression and prognosis.ResultsThe NLR had the highest AUROC, which was 0.633 (p < 0.001). The correlation test revealed that the NLR was positively correlated with serum creatinine (r = 0.127, p < 0.001) and 24-hour urine protein (r = 0.18, p < 0.001) and negatively correlated with eGFR (r = 0.14, p < 0.001). Patients with IgAN who had a high NLR were more likely to have hypertension (p = 0.003). Multivariate Cox regression analysis indicated that a high NLR was an independent risk factor for IgAN even after adjustment for important clinical and pathological parameters (p = 0.043, HR = 1.74, 95%CI: 1.02-2.97). Kaplan–Meier analysis showed that a high NLR was significantly associated with the renal prognosis of patients with IgAN (p < 0.001), especially patients with stage 3 to 4 chronic kidney disease (p = 0.028) or 24-hour urine protein of >1 g/day (p < 0.001).ConclusionAn elevated NLR affects the renal progression and prognosis in patients with IgAN and could be a marker for evaluation of renal function and pathologic lesions.

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The prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer

10.21203/rs.2.17328/v2 ◽

2020 ◽

Author(s):

Jingqi Zhang ◽

Xiaozhou Zhou ◽

Hua Ding ◽

Liwei Wang ◽

Sha Liu ◽

...

Keyword(s):

Bladder Cancer ◽

Risk Factor ◽

Prognostic Value ◽

Independent Risk Factor ◽

Blood Parameters ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Lymphocyte Ratio ◽

Kaplan Meier ◽

Muscle Invasive

Abstract Background A routine blood examination is one of the most rapid, convenient and inexpensive clinical examinations that can reflect a patient’s inflammatory status and other blood conditions, and the prognostic value of routine preoperative blood parameters in MIBC patients is still unclear, so we evaluated the prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer (MIBC) following radical cystectomy (RC). Methods Data on 202 patients with MIBC who underwent RC at our institution were retrospectively collected between October 2007 and August 2018. The median preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and hemoglobin (HGB) values were used as cutoffs to form the low and high NLR, low and high PLR, and low and high HGB groups, respectively. The clinicopathologic characteristics of each group were compared by chi-square and t tests. Kaplan-Meier survival and multivariate Cox regression analyses were used to analyze prognosis. Results The median NLR, PLR and HGB values were 2.42, 112 and 125g/L, respectively. Kaplan-Meier results showed that the low HGB group had poor progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). A high NLR and high PLR groups correlated only with poor OS. Multivariate Cox analyses showed that pathological T3/4 stage, positive lymph node status and low HGB were independent risk factors for PFS, CSS and OS, and age was the only independent risk factor for OS. Conclusion Preoperative peripheral blood HGB is an independent risk factor for the prognosis of MIBC patients. These data suggest that HGB may be a useful prognostic marker for MIBC patients undergoing RC.

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The prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer

10.21203/rs.2.17328/v3 ◽

2020 ◽

Author(s):

jingqi zhang ◽

Xiaozhou Zhou ◽

Hua Ding ◽

Liwei Wang ◽

Sha Liu ◽

...

Keyword(s):

Bladder Cancer ◽

Risk Factor ◽

Prognostic Value ◽

Independent Risk Factor ◽

Blood Parameters ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Lymphocyte Ratio ◽

Kaplan Meier ◽

Muscle Invasive

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The prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer

10.21203/rs.2.17328/v1 ◽

2019 ◽

Author(s):

jingqi zhang ◽

Xiaozhou Zhou ◽

Hua Ding ◽

Liwei Wang ◽

Sha Liu ◽

...

Keyword(s):

Bladder Cancer ◽

Risk Factor ◽

Prognostic Value ◽

Independent Risk Factor ◽

Blood Parameters ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Lymphocyte Ratio ◽

Kaplan Meier ◽

Muscle Invasive

Abstract Background A routine blood examination is one of the most rapid, convenient and inexpensive clinical examinations that can reflect a patient’s inflammatory status and other blood conditions, and the prognostic value of routine preoperative blood parameters in MIBC patients is still unclear, so we evaluated the prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer (MIBC) following radical cystectomy (RC). Methods Data on 272 patients with MIBC who underwent RC at our institution were retrospectively collected between March 2006 and August 2018. The median preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and hemoglobin (HGB) values were used as cutoffs to form the low and high NLR, low and high PLR, and low and high HGB groups, respectively. The clinicopathologic characteristics of each group were compared by chi-square and t tests. Kaplan-Meier survival and multivariate Cox regression analyses were used to analyze prognosis. Results The median NLR, PLR and HGB values were 2.48, 115 and 125, respectively. Kaplan-Meier results showed that the high NLR and low HGB groups had poor progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). A high PLR correlated only with poor OS. Multivariate Cox analyses showed that pathologic T4 stage, positive lymph node status and low HGB were independent risk factors for PFS, CSS and OS, and pathologic T3 stage was an independent risk factor for PFS and CSS; however, age was the only independent risk factor for OS. Conclusion Preoperative peripheral blood HGB is an independent risk factor for the prognosis of MIBC patients. These data suggest that HGB may be a useful prognostic marker for MIBC patients undergoing RC.

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Impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture

Hip International ◽

10.1177/11207000211028502 ◽

2021 ◽

pp. 112070002110285

Author(s):

Pradip Ramamurti ◽

Safa C Fassihi ◽

David Sacolick ◽

Alex Gu ◽

Chapman Wei ◽

...

Keyword(s):

Renal Function ◽

Risk Factor ◽

Femoral Neck ◽

Femoral Neck Fracture ◽

Impaired Renal Function ◽

Independent Risk Factor ◽

Femoral Neck Fractures ◽

Stage 4 ◽

Ckd Stage ◽

Neck Fracture

Background: The metabolic abnormalities that occur secondary to chronic kidney disease (CKD) increase the risk of femoral neck fractures compared to the general population. The purpose of this study is to determine whether impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture. Methods: The ACS-NSQIP database was reviewed for patients who underwent total hip arthroplasty, hemiarthroplasty and open reduction internal fixation (ORIF) for femoral neck fractures between 2007 and 2018. Patients were split into cohorts based on calculated estimated glomerular filtration rate. Demographic information, comorbidities, and 30-day complications were analysed with univariate and multivariate analyses using chi-square, Fischer’s exact and analysis of variance testing. Results: The total number of patients for the study was 163,717. Patients with CKD stage 4 and 5 had an increased rate of any complication (39.1 and 36.7% respectively) compared with higher eGFRs ( p < 0.001). Similarly, 30-day mortality was increased at 6.0% and 6.7% for both stage 4 and 5 ( p < 0.001). By multivariate regression, those with CKD Stage 4 and 5 were at increased risk for any complication compared to patients with a normal preoperative eGFR of 90–120 ( p < 0.001). Conclusions: This study demonstrated that patients with CKD Stage 4 and 5 are at increased risks of all complications, including death, renal, pulmonary and thromboembolic disease. Therefore, these patients should be cared for from a multidisciplinary approach with close attention to postoperative medications and fall prevention to help mitigate the risk of complications in the immediate postoperative period.

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Association of Retinol-Binding Protein 4 with Arteriovenous Fistula Dysfunction in Hemodialysis Patients

Blood Purification ◽

10.1159/000513418 ◽

2021 ◽

pp. 1-8

Author(s):

Yuanhao Wu ◽

Fan Wang ◽

Tingting Wang ◽

Yin Zheng ◽

Li You ◽

...

Keyword(s):

Risk Factor ◽

Arteriovenous Fistula ◽

Independent Risk Factor ◽

Binding Protein ◽

Retinol Binding Protein ◽

Youden Index ◽

Serum Concentrations ◽

Retinol Binding Protein 4 ◽

Kaplan Meier ◽

Increased Risk

Background: Arteriovenous fistula (AVF) is the most common vascular access for patients undergoing hemodialysis (HD). Neointimal hyperplasia (NIH) might be a potential mechanism of AVF dysfunction. Retinol-binding protein 4 (RBP4) may play an important role in the pathogenesis of NIH. The aim of this study was to investigate whether AVF dysfunction is associated with serum concentrations of RBP4 in HD subjects. Methods: A cohort of 65 Chinese patients undergoing maintenance HD was recruited between November 2017 and June 2019. The serum concentrations of RBP4 of each patient were measured with the ELISA method. Multivariate logistic regression was used to analyze data on demographics, biochemical parameters, and serum RBP4 level to predict AVF dysfunction events. The cutoff for serum RBP4 level was derived from the highest score obtained on the Youden index. Survival data were analyzed with the Cox proportional hazards regression analysis and Kaplan-Meier method. Results: Higher serum RBP4 level was observed in patients with AVF dysfunction compared to those without AVF dysfunction events (174.3 vs. 168.4 mg/L, p = 0.001). The prevalence of AVF dysfunction events was greatly higher among the high RBP4 group (37.5 vs. 4.88%, p = 0.001). In univariate analysis, serum RBP4 level was statistically significantly associated with the risk of AVF dysfunction (OR = 1.015, 95% CI 1.002–1.030, p = 0.030). In multivariate analysis, each 1.0 mg/L increase in RBP4 level was associated with a 1.023-fold-increased risk of AVF dysfunction (95% CI for OR: 1.002–1.045; p = 0.032). The Kaplan-Meier survival analysis indicated that the incidence of AVF dysfunction events in the high RBP4 group was significantly higher than that in the low-RBP4 group (p = 0.0007). Multivariate Cox regressions demonstrated that RBP4 was an independent risk factor for AVF dysfunction events in HD patients (HR = 1.015, 95% CI 1.001–1.028, p = 0.033). Conclusions: HD patients with higher serum RBP4 concentrations had a relevant higher incidence of arteriovenous dysfunction events. Serum RBP4 level was an independent risk factor for AVF dysfunction events in HD patients.

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Abstract 4331: Elevated Albumin Excretion is an Independent Risk Factor in Patients with Chronic Heart Failure. Data from the GISSI-Heart Failure Trial

Circulation ◽

10.1161/circ.118.suppl_18.s_866 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Serge Masson ◽

Luciano Moretti ◽

Ospedale Mazzoni ◽

Maria Grazia Rossi ◽

Emanuele Carbonieri ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Risk Factor ◽

Independent Risk Factor ◽

Cox Model ◽

Nyha Class ◽

Large Population ◽

Creatinine Concentration ◽

Albumin Excretion ◽

All Cause Mortality

Elevated albuminuria, a marker of endothelial renal damage, is a risk factor for cardiovascular events in the general population and in patients with diabetes or hypertension. We report here on its association with mortality in a large population of patients with chronic HF. Albuminuria (albumin/creatinine concentration ratio in a morning spot sample, UACR) was determined in 2131 patients with chronic HF enrolled in 77 centers participating to the GISSI-HF trial. Patients were divided according to normal (UACR <30 mg/g) and abnormal urinary excretion of albumin (≥30 mg/g). Association between elevated albuminuria and all-cause mortality was tested by univariable and multivariable analyses. Elevated albuminuria was found in 25.3% of the population (age 67±11 y, 78.9% males, 30.1% NYHA class III-IV, 55.5% hypertension, 26.1% diabetes) and was more frequent in older patients, those with reduced renal function, diabetes or high CRP. Mortality was significantly higher in patients with elevated albuminuria (20.1% at 1000 days) compared to normals (9.0%, p<0.0001). Elevated albuminuria remained an independent risk factor for all-cause mortality (HR [95%CI] 1.47 [1.18 –1.82]) in a Cox model adjusted for clinical risk factors such as age, gender, NYHA class, renal function, diabetes, BMI and blood pressure. About a quarter of the patients enrolled in the GISSI-HF trial had abnormal urinary albumin excretion, a marker for both renal and systemic vascular disease. We show for the first time in a large representative sample that elevated albuminuria is an independent predictor of all-cause mortality in patients with chronic HF.

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The Predictive Role of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio on Intensive Care Unit Admission and Mortality of COVID-19 Patients in Iran

10.21203/rs.3.rs-334097/v1 ◽

2021 ◽

Author(s):

Peiman Foroughi ◽

Mojtaba Varshochi ◽

Mehdi Hassanpour ◽

Meisam Amini ◽

Behnam Amini ◽

...

Keyword(s):

Intensive Care Unit ◽

Risk Factor ◽

Intensive Care ◽

Independent Risk Factor ◽

Multivariate Logistic Regression Analysis ◽

Neutrophil To Lymphocyte Ratio ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Icu Admission ◽

Inflammatory Index

Abstract Since the outbreak of COVID-19 several studies conducted to identify predictive factors which are associated with prognosis of COVID-19. In this study we aimed to determine whether the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) could help the clinicians to predict intensive care unit (ICU) admission and mortality of COVID-19 patients. This retrospective cohort study involved examining the medical records of 311 Iranian COVID-19 patients from 22 July 2020 to 22 August 2020. All characteristic data and laboratory results were recorded. The receiver operating characteristic (ROC) curve was used to identify the predictive value of studied parameters for ICU admission and death. Comparison of data revealed that some factors were jointly higher in non-survivors and ICU admitted patients than survivors and non-ICU admitted patients, such as: age, hemoglobin (HB), NLR, derived neutrophil-to-lymphocyte ratio (dNLR), PLR, systemic inflammatory index (SII), lactate dehydrogenase (LDH), Respiratory diseases, ischemic heart disease (IHD). Multivariate logistic regression analysis showed that only hypertension (OR 3.18, P=0.02) is an independent risk factor of death in COVID-19 patients, and also PLR (OR 1.02, P=0.05), hypertension (OR 4.00, P=0.002) and IHD (OR 5.15, P=0.008) were independent risk factor of ICU admission in COVID-19 patients. This study revealed that the NLR, PLR, platelet-to-white blood Cell ratio (PWR), dNLR and SII are valuable factors for predicting ICU admission and mortality of COVID-19 patients.

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GAMBARAN KADAR KREATININ SERUM PADA PENDERITA DIABETES MELLITUS TIPE 2 DI RUMAH SAKIT UMUM PUSAT SANGLAH DENPASAR

Meditory : The Journal of Medical Laboratory ◽

10.33992/m.v5i2.146 ◽

2018 ◽

Vol 5 (2) ◽

Author(s):

Ida Arjani

Keyword(s):

Diabetes Mellitus ◽

Renal Function ◽

Serum Creatinine ◽

Analytical Study ◽

Sampling Methods ◽

Chronic Complications ◽

Low Levels ◽

End Stage ◽

Dm Type 2

ABSTRACTBackground Diabetes mellitus (DM) is a metabolic disease which characterized by hyperglycemia due to abnormalities insulin secretions, insulin performance, or both of them. The condition of insulin resistance in DM type 2 causes chronic complications such as diabetic nephropathy. It has become the second leading cause of end-stage kidney disease, and one of the most common and demaging complication of diabetes. The level of creatinine in blood is one of the parameters used to assess renal function, as in the plasma concentration and excretion in the urine within 24 hours. Serum creatinine levels greater than the normal value suggests an impaired renal function. Objective The purpose of this study was to determine serum creatinine levels in patients with DM type 2 in Sanglah General Hospital Denpasar. Methods The method uses an analytical study with description, used accidental sampling methods, involving 30 patients with DM type 2. Blood samples were analyzed for creatinine levels and data are presented as table. The reslts of this study showed that 60% samples had high levels of serum creatinine, 30% samples had normal levels serum creatinine, and 10% samples had low levels serum creatinine. From the result was concluded, most patients with DM type 2 in Sanglah Genaral Hospital have highly serum creatinine levels. Keywords: creatinine serum, DM type 2

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Incidence and Predictors of Acute Kidney Injury Among Women With Severe Pre-eclampsia at Mbarara Regional Referral Hospital

10.21203/rs.3.rs-1093153/v1 ◽

2021 ◽

Author(s):

Mariam Hassan ◽

Roland Mayanja ◽

Wasswa G.M Ssalongo ◽

Natumanya Robert ◽

Lugobe Henry Mark ◽

...

Keyword(s):

Acute Kidney Injury ◽

Risk Factor ◽

Serum Creatinine ◽

Independent Risk Factor ◽

Statistical Significance ◽

Kidney Injury ◽

Referral Hospital ◽

Chronic Hypertension ◽

Baseline Serum ◽

Regional Referral Hospital

Abstract BackgroundThe presence of acute kidney injury (AKI) in pre-eclampsia complicates treatment including; increasing length of hospital stay and a need to access services like dialysis which are largely expensive in resource-limited settings. We aimed to determine incidence and predictors of acute kidney injury among women with severe pre-eclampsia at Mbarara Regional Referral Hospital in southwestern Uganda. MethodsWe carried out a hospital-based prospective cohort study from 16 November 2018 to 18 April 2019, among pregnant women with severe preeclampsia followed up in the hospital. We enrolled 70 mothers with severe pre-eclampsia and eclampsia; we excluded patients with a history of chronic renal disease, chronic hypertension, and gestational hypertension.Data on socio-demographics, laboratory parameters, health system, obstetric and medical factors were collected. Baseline serum creatinine, complete blood count, and CD4 T-cell count were all done at admission (0-hour). Second serum creatinine was done at 48-hours to determine the presence of AKI. AKI was defined as a rise in serum creatinine of 0.3mg/dl or more from the baseline. The proportion of women diagnosed with acute kidney injury among the total number of women with severe pre-eclampsia was reported as incidence proportion. Univariate and multivariate logistic regression was used to establish the association of acute kidney injury and severe pre-eclampsia.ResultsIncidence of acute kidney injury was high (41.4%) among women with severe pre-eclampsia. Antenatal care attendance was protective 0.36 (0.16, 0.80), p<0.013 at bivariate analysis but had no statistical significance at multivariate analysis. Eclampsia was an independent risk factor for acute kidney injury. (aRR 2.74 (1.06, 7.08), P<0. 037.ConclusionThe incidence of acute kidney injury in patients with preeclampsia is high. Eclampsia is an independent risk factor of acute kidney injury.

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P0292CONSTIPATION IN CHINESE ELDERLY: A HIDDEN CAUSE OF CHRONIC KIDNEY DISEASE AND THE RISK OF RAPID RENAL FUNCTION DECLINE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0292 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Guihua Jian ◽

Dongsheng Cheng ◽

Zhi Wang ◽

Junhui Li ◽

Qi Yang ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Risk Factor ◽

Retrospective Cohort ◽

Independent Risk Factor ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Renal Function Decline ◽

Ckd Stage

Abstract Background and Aims Both constipation and chronic kidney disease (CKD) are common among seniors. However, the association between constipation and CKD remain unclear. This study investigates the correlation between the two to provide a new basis for clinical treatment. Method Data from Shanghai community elderly physical examination database (2010-2018) were used to conduct a cross-sectional study and a retrospective cohort to evaluate the relationship between constipation and the prevalence of CKD and rapid renal function decline in the elderly community. Results The cross-sectional study covered 16,177 participants, with an average age of 71.3. Comparing to no constipation group, seniors with constipation have a higher proportion of suffering from CKD stage 3. Constipation is an independent risk factor contributing to the high prevalence of CKD stage 3 (OR:1.238,95% CI,1.045-1.466). This finding was further tested through a retrospective cohort study that included 4,203 participants with a medium following time of 6.1 years. As a result, 9.5% (n=401) reported to have rapid progression of renal function. After adjustment of confounding factors, the logistic regression analysis indicates that, constipation is an independent predictive variable of rapid renal function decline among aged population. Conclusion Constipation is an independent risk factor for the prevalence of CKD and an independent predictor of rapid renal function decline among seniors in the community. Prevention and treatment for constipation should be taken at an early stage, which may reduce the incidence of CKD and delay the progression of CKD.

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