Correlation Between Neutrophil / Lymphocyte Ratio And Clinical And Pathological Features Of IgA Nephropathy

Objective:IgAN is a common cause of end stage renal disease(ESRD)in China,About 30%-50%of patients will progress to ESRD within 20 years,which poses a great threat to human health.IgAN is an autoimmune disease with different clinical manifestations,It often occurs after infection.Mucosal immunity and inflammation participate in the occurrence and development of IgAN.As a new member of inflammation family,neutrophil to lymphocyte ratio(NLR)has been widely studied by scholars in recent years,and it has been found that it is related to diabetic nephropathy,chronic kidney disease and other inflammation related diseases.The purpose of this paper is to study the relationship between NLR and clinical and pathological indexes of IgAN patients,which is helpful for early detection of high-risk patients,and can provide ideas for early intervention of high-risk patients.method:200 patients with IgAN diagnosed by renal biopsy in our hospital from January 2013 to December 2019 were selected as case group,and 100 healthy people matched with age and gender in the same period,with no evidence of infection were selected as the control group.Baseline clinical data of healthy people,demographic data of IgAN patients,baseline clinical data of renal biopsy and pathological indexes were collected.The blood routine results of IgAN patients and healthy controls were analyzed and compared.According to the median of NLR,IgAN patients were divided into low NLR group and high NLR group.The differences of clinical data,Oxford classification and Lee grading between low and high NLR groups were analyzed and compared.result:1 Comparison of baseline clinical data between IgAN group and control groupThere were 200 people in IgAN group,including 98 males and 102females,with an average age of 40.50±12.59 years.There were 100 people in control group,including 48 males and 52 females,with an average age of40.88±11.99 years.The WBC,NE and NLR of IgAN group were higher than those of control group(P<0.05).Compared with the two groups,the RBC,HGB and LY of IgAN group were lower(P<0.05).There was no statistically significant difference of PLT and PLR in two groups(P>0.05).2 Comparison of demographic characteristics and laboratory parameters between low NLR group and high NLR group in IgAN patientsComparison of demographic characteristics:there were 49 males and 51females in the low NLR group,with an average age of 40.31±13.08 years.In the high NLR group,there were 49 males and 51 females,with an average age of 40.69±12.13 years.Comparison of laboratory parameters:e GFR of high NLR group was lower than that of low NLR group(P<0.05).Compared with low NLR group,high NLR group had higher WBC,PLR,24h-UP and Scr(P<0.05).3 Comparison of Lee grading and Oxford classification between low NLR group and high NLR group in IgAN patientsIn Lee grading,the low NLR group accounted for 36%of grade Ⅰ-Ⅱ,50%of grade Ⅲ and 14%of grade Ⅳ-Ⅴ;the high NLR group accounted for 20%of grade Ⅰ-Ⅱ,55%of grade Ⅲ and 25%of grade Ⅳ-Ⅴ.Compared the two groups,it was found that the pathological grade of patients in the high NLR group was higher,mainly in grade Ⅲ-Ⅴ(P=0.019).In Oxford classification,the low NLR group accounted for 73%of T0,18%of T1,9%of T2;the high NLR group accounted for 50%of T0,29%of T1,21%of T2,the comparison between the two groups found that the degree of renal tubular atrophy in high NLR group was more serious(P=0.003).4 Correlation analysis between NLR and some laboratory parameters in IgAN patientsNLR was positively correlated with WBC(r=0.330,P=0.000),BUN(r=0.187,P=0.008),24h-UP(r=0.225,P=0.001)and PLR(r=0.471,P=0.000).NLR was negatively correlated with e GFR(r=-0.235,P=0.001).5 Multiple stepwise regression analysis of NLRThe regression equation is Y=0.008PLR+0.286WBC-0.006e GFR(R~2=0.449),indicating that PLR,WBC and e GFR are the independent influencing factors of NLR.Conclusion:1 Inflammation may be common in IgAN patients.2 NLR was correlated with 24h-UP and e GFR in IgAN patients.Higher NLR ratio may indicate more severe clinical manifestations.3 NLR is a kind of inflammatory markers.High level of NLR may indicate the severity of pathological damage in patients,and it may be used as an index to predict the degree of pathological damage in IgAN patients.