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The association between platelet-lymphocyte ratio and the risk of all-cause mortality in chronic kidney disease: a systematic review and meta-analysis

  • Nephrology - Original Paper
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Abstract

Background

Chronic kidney disease (CKD) patients have high levels of inflammatory mediators. These inflammatory mediators contribute to the increased risk of cardiovascular events and all-cause mortality. Platelet-lymphocyte ratio (PLR) has recently been recognized as a novel inflammatory marker and has been shown to be associated with the prognosis in CKD patients. However, the quality of these studies varies and their results are controversial. The purpose of this meta-analysis was to investigate the relationship between PLR and all-cause mortality in CKD patients.

Methods

A systematic literature search of PubMed, EMBASE, CENTRAL and ISI Web of Science was conducted. The databases were searched from their inception dates up to the latest issue (31 October 2021). Two reviewers independently searched the databases and screened studies. Data were extracted using a standardized collection form. Meta-analysis was performed to compare PLR values between CKD and non-CKD patients, and to investigate the association between PLR and all-cause mortality in CKD patients. This meta-analysis is reported in adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Results

A total of 11 studies involving 4244 participants were selected. The pooled data indicated that PLR values were significantly higher in CKD patients than non-CKD controls (weighted mean difference = 21.6, 95% CI 17.39–25.81, p < 0.01), and PLR is associated with an increased risk of all-cause mortality in CKD patients (hazard ratio = 2.49, 95% CI 1.78–3.49, p < 0.01).

Conclusions

Patients with CKD have higher PLR values compared to non-CKD patients. Meanwhile, PLR values were highly associated with all-cause mortality in CKD patients. PLR is a valid predictor as a clinically accessible indicator for patients with CKD.

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Acknowledgements

We thank all the medical, nursing, and technical staff from the Department of Nephrology, the Central Hospital of Wuhan.

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Author notes

  1. Wenyuan Gan, Qingyu Guan and Xiaosong Hu contributed equally to this work.

Authors and Affiliations

  1. Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China

    Wenyuan Gan, Qingyu Guan, Xiaosong Hu, Xingruo Zeng, Danni Shao, Li Xu, Wei Xiao, Huihui Mao & Wenli Chen

  2. Medical School, Jianghan University, Wuhan, 430056, Hubei, China

    Qingyu Guan

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Contributions

WG, QG and XH designed the study; XZ, DS and LX collected data; WC had given professional advices on the design and perform of this study; WG, QG, XH, WX and HM analyzed the data and made the figures; WG, QG and XH drafted the paper; WC revised the paper; all authors approved the final version of the manuscript.

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Correspondence to Wenli Chen.

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All the authors declare that they have no conflict of interest. The authors have no relevant financial or non-financial interests to disclose. This article does not contain any studies with human participants performed by any of the authors.

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Gan, W., Guan, Q., Hu, X. et al. The association between platelet-lymphocyte ratio and the risk of all-cause mortality in chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol 54, 2959–2967 (2022). https://doi.org/10.1007/s11255-022-03234-0

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