Association of NLR, MLR, PLR, SII, and SIRI with the stages of chronic kidney disease - A cross-sectional study

Abstract

Objectives: Chronic Kidney Disease (CKD) is a long-standing metabolic disease manifested by renal impairment, high morbidity and mortality, and causing a huge financial burden. Systemic inflammation and local intrarenal inflammation are found to exacerbate this irreversible condition. White blood cells, platelets, and their derived indices may aid in the assessment of the progression of CKD. This study aimed to assess the alterations of complete blood count and their derived indices in the various stages of chronic kidney disease. Methods: The retrospective cross-sectional study was conducted in the Department of Biochemistry at a tertiary care hospital, Chennai, India. The data were collected from the Medical Records Department from July 2022 to June 2023. The study included chronic kidney disease patients aged 35 to 70 years of both genders. Children, pregnant women, and patients with heart and liver diseases were excluded. The data of the renal profile and complete blood count were collected. Statistical analysis was performed using SPSS software version 16. A p≤0.05 was considered statistically significant. Results: Among the study participants, 65% were male and were more than 50 years of age. All the derived inflammation index parameters, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lympho- cyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). were significantly increased in stage 5 of CKD. Also, SII and SIRI were found to be correlated with other inflammatory variables. Conclusion: Chronic inflammation is considered to be prevalent among CKD patients. Inflammatory markers such as SII and SIRI are simple and cost-effective parameters to routinely assess the staging of CKD and thus initiate appropriate management to improve the quality of life.