Background: Hypertension (HTN) is one of the most important causes of chronic kidney disease (CKD) and may
also be the presenting feature of asymptomatic primary renal disease. However, a progressive reduction in estimated
glomerular filtration rate (eGFR) and increased albuminuria indicate progressive loss of renal function, an alteration
of renal function is an insensitive marker of renal impairment because a major reduction in renal function is needed
before serum creatinine rise. Low-grade inflammation plays crucial pathophysiological role in both hypertension and
CKD.
Objective: This work was aimed to study neutrophil-to-lymphocyte ratio (NLR) as a marker for early detection of
hypertensive kidney disease and as a predictor of worsening renal function in patients with high normal blood pressure
and in hypertensive patients.
Patient and methods: This case control study included a total of 125 hypertensive patients and 50 subjects with
normal blood pressure, attending at Department of Internal Medicine, Banha University Hospital. All participants
were subjected to careful history taking, clinical examination, and laboratory investigations including NLR.
Results: NLR was significantly higher among HTN group with low eGFR (3.2±1), followed by HTN group with
normal eGFR (1.9±0.98) with p value = 0.019, while lymphocyte was significantly lower among HTN group with
low eGFR (1.7±0.3) followed by HTN group with normal eGFR (2.2±0.5) with P value 0.005. Neutrophils and NLR
were significantly higher among stage IV CKD patients (6.1±2, 3.3±1.1 respectively) followed by stage III patients
(5.8±1.4, 2.9±0.99 respectively) with p values were 0.031, 0.022 respectively. There was significant correlation
between NLR and blood pressure, urea, creatinine, eGFR, albumin/creatinine ratio, and CRP.
Conclusion: It could be concluded that NLR can be used as a marker with significant sensitivity and specificity for
hypertensive nephropathy at different CKD stages. |
