Neutrophil-lymphocyte ratio: Predicting cardiovascular and renal complications in patients with diabetes.

PURPOSE: Diabetes mellitus (DM) is a growing pandemic. The cause of mortality for most patients with DM is cardiovascular or renal complications. The purpose of this article is to discuss the emerging role of the neutrophil-lymphocyte ratio (NLR) as a prognostic marker in predicting development and progression of diabetic nephropathy (DN) as well as major adverse cardiac events (MACEs), and related mortality in patients diagnosed with DM. DATA SOURCES: A review of original research published in English identified through CINAHL and PubMed was performed.
CONCLUSIONS: Research identifies the NLR as an independent predictor of the development and progression of DN, MACE occurrence, and subsequent mortality. Studies with larger sample sizes are needed to strengthen the current evidence. Future studies must also identify specific NLR values that can be used as reference points for risk prognostication for patients. IMPLICATIONS FOR PRACTICE: Current evidence reinforces the need to consider the use of new prognostic tools for DN and cardiovascular disease in patients with DM. The use of the NLR in clinical practice can greatly improve quality of life for those with DM by establishing more effective disease management. ©2016 American Association of Nurse Practitioners.