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Prognostic value of neutrophil-to-lymphocyte ratio on proteinuria remission in patients with idiopathic membranous nephropathy

  • Nephrology - Original Paper
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Abstract

Background

As a novel marker of inflammation, the neutrophil-to-lymphocyte ratio (NLR) has been studied in various diseases. However, NLR in idiopathic membranous nephropathy (IMN) has been rarely studied. We sought to assess the role of NLR in predicting proteinuria remission in IMN.

Methods

This retrospective study involved 561 patients with IMN from January 2018 to December 2022 in Department of Nephrology of Wuhan Central Hospital. All baseline data were collected before the immunosuppressive regiment was administered. The Cox proportional hazards model and Kaplan–Meier curve were applied to assess the prognostic value of NLR for proteinuria remission.

Results

The area under the receiver operating characteristic curve revealed that the optimal cut-off NLR value for predicting proteinuria non-remission was 2.63, with a sensitivity and specificity of 58.2% and 72.7%, respectively. Kaplan–Meier curves showed a lower rate of proteinuria remission in patients with high NLR compared with low NLR (Log-rank = 5.04, p = 0.025). Multivariate Cox regression analysis showed that high NLR was an independent risk factor for proteinuria non-remission after adjustment (HR = 1.579, 95% CI 1.052–2.683, p = 0.023). Subgroup analysis indicated that high NLR was a risk factor for proteinuria non-remission especially in IMN patients with 24 h proteinuria ≥ 1 g (HR = 1.818, 95% CI 1.031–2.573, p = 0.012) and chronic kidney disease (CKD) stage 3–4 (HR = 1.935, 95% CI 1.084–2.495, p = 0.015).

Conclusion

The current study shows that NLR is an independent risk factor for proteinuria non-remission in IMN. More attention should be paid to IMN patients with high NLR, especially for those patients with 24 h proteinuria ≥ 1 g and CKD stage 3–4.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

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

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Author notes

  1. Wenyuan Gan and Jian Chen 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, Fan Zhu, Xun Fang, Xingruo Zeng, Wei Xiao & Wenli Chen

  2. Information Center, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China

    Jian Chen

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  1. Wenyuan Gan
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Contributions

WG and JC: conception and design. JC and FZ: collection and assembly of data. XF and XZ: analysis and interpretation of the data. WG: drafting of the article. WC and WX: supervision and critical revision.

Corresponding authors

Correspondence to Wei Xiao or Wenli Chen.

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The authors have declared that no conflict of interest exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the Wuhan Central Hospital at which the studies were conducted (approval number: 2021-3-01) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Gan, W., Chen, J., Zhu, F. et al. Prognostic value of neutrophil-to-lymphocyte ratio on proteinuria remission in patients with idiopathic membranous nephropathy. Int Urol Nephrol 56, 1185–1193 (2024). https://doi.org/10.1007/s11255-023-03803-x

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