Erhan Tatar1, Cem Mirili2, Tolgay Isikyakar2, Mustafa Yaprak3, Guray Guvercin2, Emine Ozay2, Gulay Asci4. 1. a Department of Nephrology , Izmir Bozyaka Education and Research Hospital , Izmir , Turkey. 2. b Department of Internal Medicine , Izmir Bozyaka Education and Research Hospital , Izmir , Turkey. 3. c Department of Nephrology , School of Medicine, Mustafa Kemal University , Hatay , Turkey. 4. d Department of Nephrology , School of Medicine, Ege University , Izmir , Turkey.
Abstract
OBJECTIVE: The purpose of this study was to investigate the association of the neutrophil/lymphocyte ratio and platelet/lymphocyte ratio with the clinical outcomes in geriatric patients with stage 3-5 chronic kidney disease (CKD). MATERIAL AND METHODS: A total of 165 patients over the age of 65, with stage 3-5 CKD, were enrolled in the study. The primary endpoints were all-cause of deaths and requirement of renal replacement therapy. The patients were divided into two groups according to delta neutrophil/lymphocyte ratio such as increased (group 1) and decreased or stable (group 2) groups. RESULTS: The mean age was 73.8 ± 6.1 years and the mean follow-up was 30 ± 13 months. Thirty-one (18.7%) patients died during the follow-up period and 21 (13.4%) patients required renal replacement therapy. The neutrophil/lymphocyte ratio increased in 95 (57.5%) patients. The mortality rate (24.2%, 11.4%; p = 0.03) and requirement of renal replacement therapy (19.1%, 5.7%; p = 0.01) were higher in group 1 compared to group 2. In the Cox regression analysis, the basal neutrophil/lymphocyte ratio was the independent predictor of death (HR: 1.23 (95% CI 1.02-1.47), p = 0.02), and the basal eGFR was the independent predictor of requirement of renal replacement therapy (HR:0.938, 95% CI: 0.888-0.991, p = 0.02). However, platelet/lymphocyte ratio was not associated with death and requirement of renal replacement therapy independently. CONCLUSION: The neutrophil/lymphocyte ratio predicts all-cause of mortality in geriatric patients with chronic kidney disease.
OBJECTIVE: The purpose of this study was to investigate the association of the neutrophil/lymphocyte ratio and platelet/lymphocyte ratio with the clinical outcomes in geriatric patients with stage 3-5 chronic kidney disease (CKD). MATERIAL AND METHODS: A total of 165 patients over the age of 65, with stage 3-5 CKD, were enrolled in the study. The primary endpoints were all-cause of deaths and requirement of renal replacement therapy. The patients were divided into two groups according to delta neutrophil/lymphocyte ratio such as increased (group 1) and decreased or stable (group 2) groups. RESULTS: The mean age was 73.8 ± 6.1 years and the mean follow-up was 30 ± 13 months. Thirty-one (18.7%) patients died during the follow-up period and 21 (13.4%) patients required renal replacement therapy. The neutrophil/lymphocyte ratio increased in 95 (57.5%) patients. The mortality rate (24.2%, 11.4%; p = 0.03) and requirement of renal replacement therapy (19.1%, 5.7%; p = 0.01) were higher in group 1 compared to group 2. In the Cox regression analysis, the basal neutrophil/lymphocyte ratio was the independent predictor of death (HR: 1.23 (95% CI 1.02-1.47), p = 0.02), and the basal eGFR was the independent predictor of requirement of renal replacement therapy (HR:0.938, 95% CI: 0.888-0.991, p = 0.02). However, platelet/lymphocyte ratio was not associated with death and requirement of renal replacement therapy independently. CONCLUSION: The neutrophil/lymphocyte ratio predicts all-cause of mortality in geriatric patients with chronic kidney disease.