Volume 21, Issue 4 pp. 370-377
Original Article

Pre-Dialysis Neutrophil-Lymphocyte Ratio, a Novel and Strong Short-Term Predictor of All-Cause Mortality in Patients With Diabetic Nephropathy: Results From a Single-Center Study

Hiroyuki Sato

Corresponding Author

Hiroyuki Sato

Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan

Address correspondence and reprint requests to Hiroyuki Sato, Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, 71 Nishimitishita Hebita, Ishinomaki, Miyagi, 986-8522, Japan. E-mail: [email protected]Search for more papers by this author
Yoichi Takeuchi

Yoichi Takeuchi

Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan

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Ken Matsuda

Ken Matsuda

Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan

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Saeko Kagaya

Saeko Kagaya

Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan

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Ayako Saito

Ayako Saito

Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan

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Hirotaka Fukami

Hirotaka Fukami

Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan

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Yoshie Ojima

Yoshie Ojima

Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan

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Tasuku Nagasawa

Tasuku Nagasawa

Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan

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First published: 30 June 2017
Citations: 13

Abstract

Neutrophil-lymphocyte ratio (NLR) is an inflammatory marker affecting the prognosis of end-stage renal disease (ESRD) patients. This study aimed to evaluate NLR levels predicting all-cause mortality in ESRD patients with diabetic nephropathy (DN), which have not been evaluated. We recruited 151 isolated DN patients who started hemodialysis between January 2009 and December 2014 at the Japanese Red Cross Ishinomaki Hospital. The primary outcomes were 1- and 3-year survival rates. The association between NLR and survival rate was evaluated using the Kaplan–Meier method and Cox proportional hazard regression analysis. Patients with an NLR ≥ 3.5 had a significantly higher mortality rate than did those with an NLR < 3.5 (log rank P = 0.02). The area under the curve (AUC) of 1-year survival for NLR was significantly larger than that for other commonly used nutritional and inflammatory variables. NLR was a more accurate predictor than other well-known markers.

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