Nghiên cứu biến đổi tỷ lệ bạch cầu trung tính /bạch cầu lympho ở bệnh nhân bệnh thận mạn tính giai đoạn cuối

Abstract

Objective: To investigate changes in the neutrophil-to-lymphocyte ratio (NLR) in end-stage chronic kidney disease (CKD) patients with and without hemodialysis (HD). Subject and method: A cross-sectional descriptive study was conducted on three groups: the HD group included 100 end-stage CKD patients undergoing hemodialysis (HD), the pre-HD group included 20 end-stage CKD patients with indications for HD but not yet on HD, and the healthy control (HC) group included 50 individuals. Result: The neutrophil-to-lymphocyte ratio (NLR) was highest in the end-stage CKD without HD group, followed by the HD end-stage CKD group, and lowest in the HC group (p=0.000). At the optimal cut-off point (2.59), 84.0% of end-stage CKD patients had elevated NLR. The prevalence of increased NLR was higher in males (80.71%), compared to females (55.82%). The median NLR in males (3.86) was significantly higher than in females (2.75), p=0.000. The end-stage CKD patients on HD aged ≥ 60 years had higher NLR compared to those < 60 years (3.47 [2.64 - 5.5] vs. 2.89 [2.04 - 4.0], p=0.029). Patients with HD duration < 12 months had higher NLR, compared to those with HD duration ≥12 months (p=0.021). Conclusion: NLR is elevated in patients with end-stage CKD, with an increased rate of 84.0%. Higher NLR values were observed in older patients and males, suggesting more severe inflammation in these subgroups. Patients on HD and those with shorter HD duration exhibited higher NLR, indicating that HD may help attenuate systemic inflammation.