NONINVASIVE PREDICTORS (PLATELET-TO-LYMPHOCYTE AND NEUTROPHIL-TO-LYMPHOCYTE RATIOS) FOR RENAL INVOLVEMENT IN SYSTEMIC LUPUS ERYTHEMATOSUS IN CLINICAL PRACTICE
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Keywords
Lupus nephritis, Neutrophil to lymphocyte, platelet to lymphocyte, SLE
Abstract
Background: Renal injury is a common complication of Systemic lupus erythematosus (SLE) and is associated with poor outcomes. However, a noninvasive method for predicting kidney dysfunction in clinical settings has not yet been established. As a result, the authors suggested that the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) could serve as reliable noninvasive indicators of renal impairment.
Aim of the Study: To study the role of Platelet-to-lymphocyte and Neutrophil-to-lymphocyte ratios as non-invasive predictors of renal involvement in Systemic Lupus Erythematosus. To compare the PLR and NLR levels, along with other renal parameters and lupus markers.
Materials: A prospective, cross-sectional study was conducted by investigating 63 patients diagnosed with SLE; the patients being divided in to four groups. 31 patients with lupus nephritis (LN) diagnosed via renal biopsy, 12 active lupus patients without renal involvement, 10 lupus patients in remission, and 60 healthy controls. The authors measured PLR and NLR levels, along with other renal and lupus markers.
Results: The results have shown that PLR and NLR had significantly higher levels in active lupus patients as in biopsy-proven LN in comparison to inactive systemic lupus erythematosus and control groups. NLR was positively correlated with serum creatinine in patients with LN; however, they did not show significant association with other predictors of renal diseases. The study demonstrated that PLR and NLR had significant association to advanced classes of LN. Furthermore, the receiver-operating characteristic curve showed a higher sensitivity of PLR in early detection of kidney function impairment in LN patients (88.9%) while NLR showed more specificity (87.5%).
Conclusion: PLR and NLR could act as noninvasive markers for detection of renal involvement in lupus patients in health clinics as for the prediction of renal pathological class.
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Dr Pradeep VR
Assistant Professor of General Medicine, Department of General Medicine, Kannur Medical College, Anjarakandy, Kannur, Kerala