Title: Association of Neutrophil Lymphocyte ratio with Diabetic Nephropathy in type 2 diabetes mellitus
Authors: Dr Naveen Sathish.V, Dr M. K. Uthaya Sankar, Dr Hanush Raj, Dr Louis Ferdin Zeno.J
DOI: https://dx.doi.org/10.18535/jmscr/v8i2.120
Abstract
Introduction: Diabetic nephropathy (DN) is a common micro‑angiopathic complication in patients with diabetes. DN is one of the most common causes of end‑stage renal disease (ESRD). DN is clinically manifested as increased albuminuria starting from microalbuminuria to macroalbuminuria and eventually ESRD. Due to this, there is a need of early predictors of DN by which we can predict the disease and can halt the progression of the disease.
Objective: To assess the association between neutrophil lymphocyte ratio and diabetic nephropathy in type 2 diabetes mellitus.
Materials and Methods: 100 consecutive type 2 diabetes patients were selected for this study and complete blood count blood sugar values, 24-hours urine protein and spot urine dipstick were done and compared.
Results: Most of the patients belong to 41-60 years of age. Of these, 14 patients had overt diabetic nephropathy (24 hrs Urine protein >300mg/dl). Neutrophil lymphocyte ratio (NLR) significantly increased in parallel to albuminuria levels with average of 2.25 in Protein excretion < 300mg/dl group and 3.2 in >300mg/dl group. There was a significant difference between the normal group and DN group with relation to NLR (p - 0.01). On comparing with urine dipstick method, there is a significant difference between urine dipstick protein in relation to 24hours urine protein excretion (P-0.02) and eGFR (0.04).
Conclusion: Neutrophil lymphocyte ratio was significantly increased in relation to albuminuria levels. When it was compared with urine dipstick protein, there was no significant correlation with NLR, but it was positively correlated with 24 hours urine protein and eGFR. NLR may serve as a cost-effective and readily accessible marker of DN.
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