Does neutrophyl to lymphocyte ratio really predict chronic kidney disease progression?

Purpose Chronic kidney disease (CKD) is an inflammatory process. In addition to increased morbidity and mortality, inflammation also contributes to the progression of CKD. Neutrophil/lymphocyte ratio (NLR) is a marker of inflammation. Some recent data suggest that NLR may predict the progression of CKD. Methods In this study, 5-year data of 740 patients with stage 2–4 CKD were reviewed retrospectively. Demographic data, NLR, CRP, albumin, the amount of proteinuria were recorded. At the beginning and the end of follow-up the glomerular filtration rate (GFR) and the annual GFR decline rate were calculated. Patients were divided to high and low NLR group according to median value of their baseline NLR. Reaching stage 5 CKD or initiation of renal replacement therapy was determined as end-point for follow-up. Results The mean age was 62.8 ± 0.57 years, eGFR 40 ml/min/1.73 m 2 , median NLR was 2.76. NLR increased as the CKD-stage increased. Mean follow-up time was 51.2 ± 30 months and 21.4% of patients reached the end-point. NLR was significantly increased at follow-up (from 3.22 to 5.68, p