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EXPRESS: Neutrophil-to-Lymphocyte Ratio as a Biomarker for Early Infection and Subsequent Mortality in Primary
Yin Zhao1, Zhiqin Chen1, Jiaoyang Li1
1Department of Nephrology and Rheumatology, The Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China.
Abstract:
ObjectivesMembranous nephropathy (MN) is the leading cause of nephrotic syndrome in adults. For primary membranous nephropathy (PMN), there are few studies analyzing the clinical and pathological characteristics as well as the role of NLR (neutrophil-to-lymphocyte ratio). To explore this, we conducted this single-center, retrospective study.MethodsThis retrospective study enrolled 138 patients with PMN who were diagnosed by renal biopsy and treated at the Affiliated Hospital of Yunnan University, China, from January 2019 to November 2024. Patients were followed up for at least 12 months. Clinical and laboratory data were collected. Intergroup comparisons, survival analyses and receiver operating characteristic (ROC) curve were performed.ResultsThe results revealed that 11 patients (7.97%) in the cohort died. Patients with infection events within the first year of follow-up had higher mortality. Compared with patients without infection events within the first year, older baseline age, higher levels of blood urea nitrogen, serum creatinine, NLR, and higher incidence of ESRD were observed in both survival with infection and non-survival with infection group. The primary infection sites were the respiratory and urinary tracts. Multivariate analyses identified age as an independent predictor of infection, while age and NLR were independent predictors of mortality. The ROC curve analysis demonstrated that the NLR may serve as a predictive marker for all-cause mortality, with an AUC of 0.778 (95% CI: 0.71-0.85). The optimal cutoff value was 2.88, achieving a sensitivity of 0.91 and specificity of 0.61.ConclusionPMN patients who developed infection events within the first year after diagnosis demonstrated higher all-cause mortality. Advanced age, impaired renal function, and elevated NLR were identified as risk factors. NLR may predict mortality and serve as an accessible biomarker.
Insights
Primary membranous nephropathy (PMN) patients with infections in the first year face higher mortality. Advanced age, poor kidney function, and high neutrophil-to-lymphocyte ratio (NLR) are risk factors, with NLR predicting mortality.
Area of Science:
- Nephrology
- Immunology
- Clinical Medicine
Background:
- Membranous nephropathy (MN) is a primary cause of nephrotic syndrome in adults.
- Primary membranous nephropathy (PMN) research lacks comprehensive analysis of clinical, pathological, and prognostic factors.
- The role of neutrophil-to-lymphocyte ratio (NLR) in PMN outcomes requires further investigation.
Purpose of the Study:
- To investigate the clinical and pathological characteristics of PMN.
- To evaluate the prognostic significance of NLR in PMN patients.
- To identify risk factors associated with mortality in PMN.
Main Methods:
- Retrospective study of 138 PMN patients diagnosed via renal biopsy.
- Data collection included clinical and laboratory parameters.
- Survival analysis and ROC curve analysis were employed to assess mortality predictors.
Main Results:
- Infection within the first year post-diagnosis correlated with increased all-cause mortality.
- Older age, elevated blood urea nitrogen, serum creatinine, and NLR were associated with higher mortality.
- NLR demonstrated predictive value for all-cause mortality (AUC=0.778), with an optimal cutoff of 2.88.
Conclusions:
- Infection events in the first year significantly increase mortality risk in PMN patients.
- Advanced age, impaired renal function, and elevated NLR are independent risk factors for mortality.
- NLR serves as an accessible and valuable biomarker for predicting mortality in PMN.