RELATIONSHIP BETWEEN NEUTROPHIL - LYMPHOCYTE RATIO AND DECREASED GLOMERULAR FILTRATION RATE IN DIABETIC NEPHROPATHY

Authors

  • Asriyani Azikin Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University, Makassar
  • Fitriani Mangarengi Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University, Makassar
  • Uleng Bahrun Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University, Makassar

DOI:

https://doi.org/10.24293/ijcpml.v24i2.1311

Keywords:

ABSTRACT Diabetic nephropathy is one of the fairly severe Diabetes Mellitus (DM) complications and the main cause of renal failure that can result in mortality. Hyperglycemia in DM induces kidney injury that may result in hemodynamic and metabolic alterat

Abstract

Diabetic nephropathy is one of the fairly severe Diabetes Mellitus (DM) complications and the main cause of renal failure that can result in mortality. Hyperglycemia in DM induces kidney injury that may result in hemodynamic and metabolic alterations, endothelial dysfunction and inflammatory cells activation. A persistent and continuous inflammation is observed in diabetic nephropathy. One of the inflammation process progression indicators is Neutrophil-Lymphocyte Ratio (NLR). To find out the relationship between NLR and decreased Glomerular Filtration Rate (GFR) in diabetic nephropathy. This study was an observational study with a retrospective approach. This study was conducted in Clinical Pathology Laboratory Installation and Medical Record Installation of Dr. Wahidin Sudirohusodo Makassar Hospital by collecting the patient's data during February 2015 to February 2016. Patients that were diagnosed as type 2 DM without diabetic nephropathy complication were taken as control and those diagnosed as type 2 DM with diabetic nephropathy were treated as study subjects. One hundred and thirteen (113) samples met the inclusion criteria, consisting of 73 diabetic nephropathy patients with Chronic Kidney Disease (CKD) 13 diabetic nephropathy patients without CKD and 27 type 2 DM patients without diabetic nephropathy complication. Patients consisted of 57 males (50.4%) and 56 females (49,6%). Neutrophil-lymphocyte ratio and GFR values in the group of diabetic nephropathy without CKD were 2.03±0.68 and 85.38±24.63, respectively. Whereas, the NLR and GFR values in control group were 1.74±0.54 and 90.03±28.60, respectively. In the group of diabetic nephropathy with CKD, NLR value increased by 3.19±1.83 and GFR decrease by 30.54±16.45. Spearman test indicated a significant relationship between NLR increase and decreased GFR (r = -0.635, p=0.00). There is a significant relationship between  NLR increase and decreased GFR in patients with diabetic nephropathy.

 

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References

Purwanto Edi. korelasi jumlah neutrofil, limfosit, dan monosit dengan kadar albumin urin pada pasien dm tipe-2. Department of Clinical Pathology Science of Diponegoro University. Jurnal Biomedika. 2009;1(1): 7-17

American diabetes association. hypertension management in adults with diabetic. Diabetic Care). 2004; (Suppl 1): 65-67.

Shikata K, Makino H. microinflammation in the pathogenesis of diabetic nephropathy in journal of diabetes investigation. Asian Association for Study of Diabetes and Wiley Publishing Asia Ltd. 2013; 4(1): 142-149.

Lestaningsih. hipertensi pada diabetik PIT V, PERKENI. Semarang, 2004; 1-5.

Lim AK, tesch gh. review article: inflammation in diabetic nephropathy. Hindawi Publishing Corporation Mediators Inflammation Journal, 2012; 2012(1): 146-154.

Lubis HR. penyakit ginjal diabetik dalam ilmu ajar penyakit dalam. 5th Ed., 2nd bundle. Jakarta, Interna publishing. 2009; 979-982.

Kato S, Abe T, lindholm b. neutrophil lymphocyte ratio a promising prognostic marker in patients with chronic kidney disease. Inflammation and Cell Signaling, 2015; 1-5. Available at:http;//www. Smartscitech.com/index.php/ics.

Abbas AK, Litchman AH. Basic Immunology. 3rd Ed Updated., Philadelphia, The United States of America, Saunder Elsevier. 2011; 27-54.

Zahorec R. ratio of neutrophil to lymphocyte counts – rapid and simple parameter of systemic inflammation and stress in critically ill. Dept. of Anaesthesia and Intensive Care Medicine. Slovakia. 2001; 102(1):5-14

Nakhjavani M, Aghajani AN, Salabati M, Mahmoudzadeh R, Morteza A, et al. changes in leucocyte subpopulation with declined glomerular filtration rate in patients with type 2 diabetes. department of endocrinology, endocrinology and metabolism research center, Tehran University. Iran, Acta Medica Iranica, 2015; 53(7): 425-431.

Akbas EM, Demirtas L, Ozcicek A, Timuroglu A, Murat E, et al. association of epicardial adipose tissue, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio with diabetic nephropathy. Department of Endocrinology, Internal Medicine, Nephrology, Erzinchan University. Turkey, International Journal of Clinical and Experimental Medicine, 2014; 7(7):1794-1801.

Covacs LG. Diabetic Nephropathy in New Trend in Classification, diagnosis and management of kidney diseases. division of nephrology, department of internal medicine. Clinical Hospital Merkur Zagreb Croatia. 2008; 1-9.

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Submitted

2018-09-30

Accepted

2018-09-30

Published

2018-09-30

How to Cite

[1]
Azikin, A., Mangarengi, F. and Bahrun, U. 2018. RELATIONSHIP BETWEEN NEUTROPHIL - LYMPHOCYTE RATIO AND DECREASED GLOMERULAR FILTRATION RATE IN DIABETIC NEPHROPATHY. INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY. 24, 2 (Sep. 2018), 131–135. DOI:https://doi.org/10.24293/ijcpml.v24i2.1311.

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