Analysis of Pre-and Post-operative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Acute Kidney Injury After Coronary Artery Bypass Grafting Surgery
Abstract
Acute Kidney Injury (AKI) remains a common complication of post-operative Coronary Artery Bypass Grafting (CABG)
related to high morbidity and mortality. Systemic inflammation has been known as a part of the pathogenesis of acute kidney
injury. This study aimed to analyze the Neutrophil Lymphocyte (N/L) ratio and Platelet Lymphocyte (P/L) ratio in post-operative
AKI. This research was a retrospective study involving 76 patients who underwent CABG surgery in Dr. Wahidin Sudirohusodo
Central Hospital, Makassar, between January 2015 and May 2019. The diagnosis of AKI was based on Kidney Disease Improving
Global Outcomes (KDIGO) 2012 criteria. The N/L ratio and P/L ratio were calculated respectively as a neutrophil count ratio to
lymphocyte count and platelet count to lymphocyte count. Twenty-five (32.9%) patients developed AKI in the first 48 hours of
the post-operative period. There was no difference in pre-operative N/L ratio and the P/L ratio between AKI and non-AKI
groups (p > 0.05). Both ratios increased after surgery and were significantly different between the two groups with higher mean
ratio in non-AKI (16.93±9.16 vs. 21.86±11.13, p=0.040 and 239,24±184,36 vs. 314,49±143,73, p=0.011). Both pre-operative
and post-operative N/L ratio and P/L ratio could not distinguish AKI after CABG.
Keywords
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Diodato M, Chedrawy EG. Coronary artery bypass graft
surgery: The past, present, and future of myocardial
revascularization. Hindawi Publishing Corporation.
Available from: https://www.ncbi.nlm.
nih.gov>pmc. (accessed 18 August, 2019).
Kirali K, Sacli H. Coronary artery bypass grafting.
I N T E C H . 2 0 1 5 . A v a i l a b l e f r o m : h t t p : / / w w w .
researchgate.net/publication/284166735. (accessed
August, 2019).
Unal EU, Durukan AB, Ozen A, Kubat E, Kocabeyoglu
SS, et al. Neutrophil/lymphocyte ratio as a mortality
predictor following coronary artery bypass graft
surgery. 2013. Available from: www.tgkdc.dergisi.org.
(accessed 12 August, 2019).
Ryden L, Sartipy U, Evans M, Hozmann MJ. Acute
kidney injury after coronary artery bypass grafting and
long-term risk of end-stage renal disease. 2014.
Available from: http://circ.ahajournal.org. (accessed
May, 2019).
Stallwood MI, Grayson. AD, Mills K, Scawn ND. Acute
renal failure in coronary artery bypass surgery:
Independent effect of cardiopulmonary bypass.
Elsevier. 2004. Available from: https://www.ncbi.
nlm.nih.gov. (accessed 13 May, 2019).
Barkhordari K, Yesseri AM, Yousefshah F, Shafiee A. Risk
factors for acute kidney injury in coronary artery bypass
graft surgery patients based on the acute kidney injury
network criteria. The Journal of Tehran University Heart
Center. 2017. Available from: https://www.ncbi.
nlm.nih.gov. (accessed 29 June, 2019).
Gude D, Jha R. Acute kidney injury following cardiac
surgery. Annals of Cardiac Anaesthesia. 2012.
Available from: http://www.annals. (accessed 17
August, 2019).
O'Neal JB, Shaw AD. Billing IV FT. Acute kidney injury
following cardiac surgery, current understanding, and
future directions. BioMed Central. 2016 Available
from: https://www.ncbi.nlm.nih.gov>pmc (accessed
August, 2019).
Nadim MK, Forni LG, Bihorac A, Hobson C, Koyner JL,
et al. Cardiac and vascular surgery-associated acute
th kidney injury: The 20 International Consensus
Conference of the ADQI (Acute Disease Quality
Initiative) Group. Wiley. 2019. Available from:
https://ahajournal.org. (accessed 21 July, 2019).
Kim WH, Park JY, Ok SH, Shin IW, Sohn JT. Association
between the neutrophil/lymphocyte ratio and acute
kidney injury after cardiovascular surgery. Medicine.
Available from: www.md-journal.com. (accessed
August, 2019).
Hancerliogullari O, Kaymak S, Okuyucu K, Ince S,
Senocak R, et al. Clinical and prognostic significance of
pre-operative and post-operative neutrophil/
lymphocyte ratio and platelet/lymphocyte ratio in
patients undergoing major abdominal surgery.
Gulhane Medical Journal, 2018. Available from:
https://www.researchgate.net. (accessed 19 May,
.
Nuchpramool P, Hanprasertpong J. Pre-operative
neutrophil-lymphocyte ratio, and platelet-lymphocyte
ratio are not clinically useful in predicting prognosis in
early-stage cervical cancer. Hindawi Publishing
Corporation. 2018. Available from: https://www.
hindawi.com. (accessed 18 August, 2019).
Serrano Jr CV, R De Mattos FR, Pitta FG, Nomura CH,
De Lemos J, et al. Association between
neutrophil-lymphocyte and platelet-lymphocyte
ratios and coronary artery calcification score among
asymptomatic patients: Data from a cross-sectional
study. Hindawi Publishing Corporation. 2019.
Available from: https://www.hindawi.com>journals.
(accessed 19 May, 2019).
Yilmaz H, Cakmak M, Inan O, Darcin T, Akcay A. Can
neutrophil-lymphocyte ratio be independent risk
factor for predicting acute kidney injury in patients
with severe sepsis?. Taylor & Francis. 2014. Available
from: https://www.tandfonline.com/action/journal
information?journalCode=irnf20. (accessed 12
August, 2019).
Parlar H, Saskin H. Are pre-and post-operative platelet
to lymphocyte ratio and neutrophil to lymphocyte
ratio associated with early post-operative AKI
following CABG?. Brazilian Journal of Cardiovascular
Surgery. 2018. Available from: www.scielo.br>scielo.
(accessed 13 May, 2019).
Okusa MD, Davenport A, Reading between the (guide)
lines-the KDIGO practice guideline on acute kidney injury in the individual patient. NIH Public Access.
Available from: https://www.ncbi.nlm.nih.
gov>pmc. (accessed 7 August, 2019).
Olsson D, Sartipy U, Braunschweig F, Holzmann MJ.
Acute kidney injury following coronary artery bypass
surgery and long-term risk of heart failure. Circ Heart
fail. 2012. Available from: http://circheartfailure.
ahajournals.org. (accessed 15 August, 2019).
Mariscalco G, Lorusso R, Dominici C, Renzulli A, Sala A.
Acute kidney injury: A relevant complication after
cardiac surgery. Elsevier, 2011. Available from:
https://www.researchgate.net>5. (accessed 13 May,
.
Silberman S, Abu-Yunis U, Tauber R, Shavit L,
Grenader T, et al. Neutrophil-lymphocyte ratio:
prognostic impact in heart surgery. Early outcomes
and late survival. Elsevier, 2018. Available from:
http://dx.doi.org/10.1016/j.thoracsur.2017.07.033.
(accessed 18 August, 2019)
Zou ZY, Liu HL, Ning N, Li SY, Du XH, Li R. Clinical
significance of pre-operative neutrophil-lymphocyte
ratio and platelet lymphocyte ratio as prognostic
factors for patients with colorectal cancer. Oncology,
Letters 11. 2016. Available from: https://www.
ncbi.nlm.nih.gov>pmc. (accessed 30 June, 2019).
Gungora H, Babu AS, Zencir C, Akpek M, Selvi M, et al.
Association of pre-operative platelet-to lymphocyte
ratio with atrial fibrillation after coronary artery bypass
graft surgery. Karger Open access. 2016. Available
from: https://www.researchgate.net>3. (accessed 19
May, 2019).
Anselmi A, Possati G, Gaudino M. Post-operative
inflammatory reaction and atrial fibrillation: Simple
correlation or causation?. Elsevier, 2009. Available
from: https://www.ncbi.nlm.nih.gov>pmc. (accessed
August, 2019).
Durukan AB, Gurbuz HA, Unal EU, Tavlassoglu M,
Durukan E, et al. Role of neutrophil/lymphocyte ratio
in assessing the risk of post-operative atrial fibrillation.
J Cardiovasc Surg. 2013. Available from:
https://www.researchgate.net/publication/25803895
(accessed 21 August, 2019).
DOI: http://dx.doi.org/10.24293/ijcpml.v27i1.1626
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