Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in evaluation of the development of polycystic kidney disease

Background: It is well known that the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are available markers of systemic inflammation, and increased inflammation is along with progress of chronic kidney disease (CKD). The inflammation is risk factors for increased morbidity and mortality in autosomal dominant polycystic kidney disease (ADPKD). Therefore, we evaluate the association between the NLR and PLR level and unfavorable prognosis in ADPKD patients. Methods: A total of 65 ADPKD patients with preserved renal function, 50 ADPKD patients with end-stage renal disease (ESRD) need dialysis and 32 healthy volunteers were included. The level of NLR and PLR were recorded in different stages of ADPKD patients, and investigated if NLR and PLR could predict development of ADPKD. We also examined the expression of inflammation marker in renal interstitium of ADPKD patients. Results: The level of NLR (5.22 ± 2.91 vs 3.38 ± 2.03, P < 0.001) and PLR (203.8 ± 121 vs 152.2 ± 70.9, P < 0.001) were significantly higher in ADPKD patients with dialysis than ADPKD patients without dialysis, and the level of NLR (3.38 ± 2.03 vs 1.42 ± 0.58, P < 0.0001) and PLR (152.2 ± 70.9 vs 92.7 ± 26.9, P < 0.0001) were significantly higher in ADPKD patients without dialysis than in controls. Increased NLR over 4.3 and PLR over 174 were related to increase the events of dialysis. A cutoff value for NLR > 2.65 and PLR > 130.2 could predict development of renal function deficit (RFD) with the sensitivity 74.7%, 66.7% and specificity 96.9%, 96.9%, respectively. In addition, the CD45 staining significantly increased in ADPKD groups. Conclusions: We conclude that NLR and PLR are significantly higher in ADPKD patients with RFD and increase across worsening CKD stages. Our data suggest that lower NLR and PLR level may be potential and novel preventive and therapeutic options for ADPKD patients.