Neutrophil to lymphocyte ratio as a marker of diabetic nephropathy

Abstract

Aim of the study is to estimate and analyze neutrophil to lymphocyte ratio (NLR) in diabetes mellitus as a marker of diabetic nephropathy (DN). Forty individuals with DN and forty patients with diabetes mellitus without nephropathy were enrolled. Inclusion criteria included patients with diabetic nephropathy (albuminuria >30 mg/day and/or eGFR <60 mL/min/1.73 m2) in the absence of additional kidney damage symptoms. Complete blood count, glycated haemoglobin (HbA1c), 24-hour urine albumin and serum creatinine were evaluated and compared. The mean NLR of the patients with DN (Cases) was 3.09 ± 0.88 (1.34-4.91) and in patients with diabetes mellitus only (Controls) it was 2.17 ± 0.69 (0.89-3.98). The correlation between urinary albumin excretion (p value =0.0004) and estimated glomerular filtration rate (p value =0.0002) also came out positive and negative respectively. Based on unpaired t-test, the difference between NLR values among the group came out statistically highly significant (p < 0.05). Thus, the NLR in both groups was not comparable. NLR was substantially higher in diabetic nephropathy patients compared to diabetes mellitus patients. Thus, NLR provides us with a simple and low-cost assessment that may be employed as a predictive instrument to diagnose diabetic nephropathy at a preliminary phase.