Correlation between neutrophil-lymphocyte ratio and renal tubular atrophy/interstitial fibrosis in patients with IgA nephropathy
Objective:To explore the relationship between the neutrophil-lymphocyte ratio (NLR) and renal tubular atrophy/interstitial fibrosis in patients with IgA nephropathy (IgAN) and investigate whether NLR can be used as an indicator to assess the severity of IgAN.Methods:A total of 161 patients with primary IgAN confirmed by renal biopsy who were admitted to the Department of Nephrology of Anqing Municipal Hospital from January 2018 to February 2023 were included in the study. The patients were divided into two groups according to the median NLR. The clinical indicators and pathological features were compared between the two groups, and the correlation between the NLR and renal tubular atrophy/interstitial fibrosis was assessed by Spearman rank correlation analysis. Univariate and multivariate linear regression analysis were used to analyze the factors associated with renal tubular atrophy/interstitial fibrosis. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the optimal cut-off value, sensitivity, and specificity of NLR for predicting moderate to severe renal tubular atrophy/interstitial fibrosis in patients with IgAN.Results:The systolic blood pressure, diastolic blood pressure, white blood cell count, neutrophil count, urea nitrogen, creatinine, and 24-h urine protein level increased and the lymphocyte count, hemoglobin, and eGFR decreased with the increase of the NLR level (P<0.05). The percentages of patients glomerulosclerosis, renal tubular atrophy/interstitial fibrosis, and T1+T2 lesions were higher in patients with a higher level of NLR (P<0.05). The results of Spearman rank correlation analysis showed that there was a correlation between the levels of NLR and the percentage of patients with renal tubular atrophy/interstitial fibrosis in patients with IgAN (r=0.440, P<0.001). Multiple linear regression analysis showed that NLR was independently and positively associated with the degree of renal tubular atrophy/interstitial fibrosis in patients with IgAN (β=0.155, t=2.539, P=0.012). ROC curve analysis showed that the optimal cut-off value of NLR to predict moderate to severe renal tubular atrophy/interstitial fibrosis was 1.946 and the area under the curve was 0.719 with a sensitivity of 84.80% and specificity of 57.00%.Conclusion:NLR is closely related to renal tubular atrophy/interstitial fibrosis in patients with IgAN and can be used as a marker to assess the severity of IgAN.
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