THE IMPORTANCE OF DETERMING THE RATIO OF NEUTROPHILS AND ALBUMIN RATIO IN PATIENTS WITH CHRONIC KIDNEY DISEASE : A FIVE YEAR FOLLOW-UP

 

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https://storage.unitedwebnetwork.com/files/1099/4346a6e6a9358a1bc9b313ccdaf6d01e.pdf
THE IMPORTANCE OF DETERMING THE RATIO OF NEUTROPHILS AND ALBUMIN RATIO IN PATIENTS WITH CHRONIC KIDNEY DISEASE : A FIVE YEAR FOLLOW-UP

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Milica
Petrovic
Milica Petrovic drmilicapetrovic@gmail.com Military Medical Academy Clinic of nephrology Belgrade Serbia *
Violeta Rabrenovic violettarab@gmail.com Military Medical Academy Clinic of nephrology Belgrade Serbia -
Dejan Pilcevic dejan.pilcevic@gmail.com Military Medical Academy Clinic of nephrology Belgrade Serbia -
Nemanja Rancic nece84@hotmail.com Military Medical Academy Center for Clinical Pharmacology Belgrade Serbia -
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Neutrophil-albumin ratio (NPAR) has been identified as a prognostic indicator of mortality from various diseases: however, its association with the progression of chronic kidney disease and the development of cardiovascular complications is insufficiently studied. The aim of this research was to examine the relationship between serum NPAR and the prognosis of patients with chronic kidney disease, stage I-V.

The study included a group of 90 patients with CKD who did not initially start treatment with any of the methods for replacing renal function and who had no history of cardiovascular or cerebrovascular events. Their average age was 56.09±10.8 years, men were more often 62.22%, compared to women 37.8%. According to GFR values, patients were divided into two groups: group G1, GFR ≥ 60 ml/min/1.73m2, 51 of them, and group G2, GFR < 60 ml/min/1.73m2, 39 patients. We retrospectively analyzed the outcome of patients after five years of follow-up. Inflammation biomarkers were determined for all patients: NLR (Ne/Ly), SII(Tr x Ne/Ly), SIRI (Ne x Mo)/Ly, IAR (Il6/Albumin) and NPAR(%Ne/albumin) in order to assess their association with CKD progression and death.

After five years of follow-up in a study of 90 subjects with CKD, 54 (60%) remained. Due to the development of terminal renal failure, 30 (33.3%) started treatment: hemodialysis (HD) 22 (24.44%), peritoneal dialysis (PD) 4 (4.44%) and kidney transplantation (Tx) 4 (4.44%). The fatal outcome occurred in 6 (6.66%). The cause of death in 4 (66.66%) was a cardiovascular event, and in 2 (33.33%) a malignant disease. Progression of CKD was more common in group II, 27 (69.23%) compared to group I: 8 (15.68%). The fatal outcome occurred in 6 (6.66%). The cause of death in 4 (66.66%) was a cardiovascular event, and in 2 (33.33%) a malignant disease. Progression of CKD was more common in group II, 27 (69.23%) compared to group I: 8 (15.68%). Examining the association of inflammation biomarkers between the group of patients without CKD progression and the group of patients who started treatment: HD, PD or Tx verified statistical significance for NPAR (p <0.0001), NLR, PLR and SII (p<0.001) and SIRI (p<0.05). Between the group without CKD progression and the group of patients with a fatal outcome, statistical significance was verified for: SII (p < 0.0001), PLR, SIRI and NPAR (p<0.05), and in patients with a fatal outcome from CVD: NPAR p<0.0001, SII p<0.001 and PLR <0.05. Analysis of patients according to gender, age, body mass index and smoking status did not verify statistical significance with biomarkers of inflammation.

NPAR can serve as a biomarker of chronic kidney disease progression and a prognostic factor of cardiovascular mortality.

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