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Immature granulocytes as biomarkers of inflammation in children with predialysis chronic kidney disease

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Abstract

Background

Chronic inflammation in patients with predialysis chronic kidney disease (CKD) is quite common. We aimed to investigate the relationship of the percentage of immature granulocytes (IG%) and immature granulocyte count (IGC) with inflammation in children with predialysis CKD.

Methods

The data from children with stage 2–4 CKD and a control group of healthy children were evaluated retrospectively. A highly-sensitive C-reactive protein (hs-CRP) level above 5 mg/dL was considered the presence of inflammation. The IGCs were calculated in the white cell differential channel of the Sysmex XN-9000 using the fluorescent flow cytometry method. The IG% was expressed as percentage of total leucocyte concentration.

Results

The data from 57 patients (30 stage 2 CKD, 15 stage 3 CKD, 12 stage 4 CKD) and 46 controls were analyzed. hs-CRP levels, IG%, IGC, white blood cell (WBC) and neutrophil counts, and neutrophil-to-lymphocyte ratio (NLR) were higher in patients than the control group (p < 0.000, p < 0.000, p < 0.000, p = 0.001, p = 0.002, p < 0.000, respectively). Both IG% and IGC were positively correlated with hs-CRP, WBC and neutrophil counts, and NLR (r = 0.485, p < 0.000; r = 0.379, p = 0.004; r = 0.543, p < 0.000; r = 0.628, p < 0.000 for IG%; r = 0.379, p = 0.004; r = 0.351, p = 0.007; r = 0.525, p < 0.000; r = 0.601, p < 0.000 for IGC, respectively). A ROC analysis of the relationship between IGC, IG%, and inflammation showed IGC and IG% had predictive value for the presence of inflammation (cut-off value: 0.035 × 106/mL, AUC: 0.799 ± 0.061, sensitivity: 74.2%, specifity: 63%, p < 0.001 for IGC; cut-off value: 0.45%, AUC: 0.838 ± 0.056, sensitivity: 70.8%, specifity: 67.3%, p = 0.001 for IG%).

Conclusions

Immature granulocytes may be used as a biomarker of inflammation in children with predialysis CKD.

Graphical abstract

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, TR-26480, Eskisehir, Turkey

    Nuran Cetın & Aslı Kavaz Tufan

  2. Department of Medical Biochemistry, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey

    Evin Kocaturk, Zeynep Kusku Kıraz & Ozkan Alatas

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  1. Nuran Cetın
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  2. Evin Kocaturk
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  3. Aslı Kavaz Tufan
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  4. Zeynep Kusku Kıraz
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  5. Ozkan Alatas
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Contributions

Research conception and design: Nuran Cetin. Data acquisition: Nuran Cetin, Evin Kocatürk, Aslı Kavaz Tufan. Statistical analysis: Nuran Cetin, Evin Kocatürk, Aslı Kavaz Tufan. Data analysis and interpretation: Nuran Cetin, Evin Kocatürk, Zeynep Küskü Kiraz, Ozkan Alatas. Drafting of the manuscript: Nuran Cetin, Evin Kocatürk. Critical revision of the manuscript: Nuran Cetin, Aslı Kavaz Tufan, Zeynep Küskü Kiraz, Ozkan Alatas. Obtaining funding: Nuran Cetin, Evin Kocatürk, Aslı Kavaz Tufan. Supervision: Zeynep Küskü Kiraz, Ozkan Alatas. Approval of the final manuscript: All authors approved the final manuscript.

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Correspondence to Nuran Cetın.

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Cetın, N., Kocaturk, E., Tufan, A.K. et al. Immature granulocytes as biomarkers of inflammation in children with predialysis chronic kidney disease. Pediatr Nephrol 38, 219–225 (2023). https://doi.org/10.1007/s00467-022-05530-4

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  • DOI: https://doi.org/10.1007/s00467-022-05530-4

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