The Value of Peripheral Blood Cell Ratios in Primary Membranous Nephropathy: A Single Center Retrospective Study

Figures & data

Figure 1 Flow diagram of the study population selection.

Abbreviation: PMN, primary membranous nephropathy.

Table 1 Comparison of the Included and Excluded PMN Patients

Characteristic	PMN Patients n=168	Included n=118	Excluded n=50	P value^a
Gender (male/female)	99/69	70/48	29/21	0.873
Age (years)	53.6±12.5	52.9±12.1	55.5±13.7	0.251
PLA2R Ab titer (RU/mL)	47.25 (0.00–129.02)	58.13 (0.00–155.97)	30.00 (0.00–86.27)	0.206
UTP (g)	3.61 (2.01–5.34)	3.72 (2.04–5.48)	3.14 (1.71–5.23)	0.317
ALB (g/L)	24.2±5.6	24.6±5.7	23.1±5.4	0.150
Cr (µmol/L)	67.3 (57.8–80.8)	66.6 (57.0–78.0)	70.6 (61.2–91.5)	0.101
NLR	2.00 (1.52–2.78)	2.01 (1.51–2.70)	1.95 (1.52–3.00)	0.522
MLR	0.18 (0.14–0.24)	0.18 (0.14–0.22)	0.19 (0.14–0.27)	0.231
PLR	121.54 (92.27–167.84)	121.06 (91.66–161.41)	125.24 (95.05–208.48)	0.142
SII	484.57 (384.21–715.27)	480.30 (351.07–700.76)	507.73 (306.96–813.33)	0.505

Note: ^aP value was used to indicate the differences between the included and excluded PMN patients.

Abbreviations: PMN, primary membranous nephropathy; UTP, 24-h urinary protein at baseline; ALB, serum albumin at baseline; Cr, serum creatinine at baseline; NLR, neutrophil–lymphocyte ratio; MLR, monocyte–lymphocyte ratio; PLR, platelet-to-lymphocyte ratio at baseline; SII, systemic immune-inflammation index.

Table 2 Comparison of Improved ALB Group and Control Group

Characteristic	Improved ALB Group n=78	Control Group n=40	P value
Gender (male/female)	43/35	27/13	0.195
Age (years)	53.4±12.0	52.0±12.4	0.563
PLA2R Ab (±)	43/35	32/8	0.008^a
PLA2R Ab titer (RU/mL)	42.86 (0.00–90.51)	106.26 (34.21–274.34)	0.001^a
UTP (g)	3.21 (1.69–5.13)	4.24 (2.87–6.08)	0.011^b
ALB (g/L)	26.0±5.6	21.9±5.0	<0.001^c
Cr (µmol/L)	69.8±23.0	71.5±18.7	0.668
Neutrophil (×10^9/L)	4.11±1.40	4.29±1.75	0.550
Lymphocyte (×10^9/L)	2.05±0.70	2.13±0.81	0.569
Monocyte (×10^9/L)	0.37±0.13	0.39±0.17	0.291
Platelet (×10^9/L)	239.55±81.41	267.08±113.40	0.132
NLR	1.96 (1.51–2.69)	2.20 (1.51–2.92)	0.710
MLR	0.18 (0.14–0.22)	0.19 (0.12–0.23)	0.676
PLR	119.70 (89.83–156.78)	121.26 (92.34–180.61)	0.535
SII	476.71 (345.53–635.76)	480.70 (369.57–818.00)	0.488
IgG IFA	3.3±0.5	3.4±0.5	0.440
C3 IFA	1.0 (1.0–2.0)	2.0 (1.0–3.0)	0.029^b
Immunosuppressive therapy (yes/no)	56/22	33/7	0.201

Notes: ^aP<0.01; ^bP<0.05; ^cP<0.001.

Abbreviations: PLA2R Ab, PLA2R Ab qualitative test; UTP, 24-h urinary protein at baseline; ALB, serum albumin at baseline; Cr, serum creatinine at baseline; Neutrophil, peripheral blood neutrophil count; Lymphocyte, peripheral blood lymphocyte count; Monocyte, peripheral blood monocyte count; Platelet, peripheral blood platelet count; NLR, neutrophil–lymphocyte ratio; MLR, monocyte–lymphocyte ratio; PLR, platelet-to-lymphocyte ratio at baseline; SII, systemic immune-inflammation index; IFA, semiquantitative direct immunofluorescence analysis of renal biopsy samples; IgG, immunoglobulin G; C3, complement C3.

Table 3 Comparison of CR Group and Control Group

Characteristic	CR Group n=75	Control Group n=43	P value
Gender (male/female)	42/33	28/15	0.332
Age (years)	54.0±11.9	50.9±12.4	0.181
PLA2R Ab (±)	41/34	34/9	0.008^a
PLA2R Ab titer (RU/mL)	43.46 (0.00–90.30)	91.15 (30.69–255.77)	0.002^a
UTP (g)	3.73 (1.79–5.15)	3.71 (2.69–5.86)	0.305
ALB (g/L)	25.3±5.5	23.4±5.9	0.082
Cr (µmol/L)	68.2±15.7	74.1±29.0	0.149
Neutrophil (×10^9/L)	4.07±1.35	4.32±1.79	0.405
Lymphocyte (×10^9/L)	2.12±0.76	2.02±0.69	0.494
Monocyte (×10^9/L)	0.38±0.13	0.37±0.16	0.814
Platelet (×10^9/L)	244.75±73.26	267.47±109.62	0.181
NLR	1.92 (1.53–2.69)	2.22 (1.51–2.96)	0.328
MLR	0.18 (0.14–0.23)	0.19 (0.12–0.22)	0.625
PLR	117.83 (88.13–155.97)	130.42 (100.00–178.33)	0.095
SII	452.86 (350.00–615.07)	520.63 (351.43–824.44)	0.168
IgG IFA	3.3±0.5	3.4±0.5	0.440
C3 IFA	1.5 (1.0–3.0)	1.5 (1.0–2.1)	0.831
Immunosuppressive therapy (yes/no)	55/20	34/9	0.486

Note: ^aP<0.01.

Abbreviations: CR, complete remission; PLA2R Ab, PLA2R Ab qualitative test; UTP, 24-h urinary protein at baseline; ALB, serum albumin at baseline; Cr, serum creatinine at baseline; Neutrophil, peripheral blood neutrophil count; Lymphocyte, peripheral blood lymphocyte count; Monocyte, peripheral blood monocyte count; Platelet, peripheral blood platelet count; NLR, neutrophil–lymphocyte ratio; MLR, monocyte–lymphocyte ratio; PLR, platelet-to-lymphocyte ratio at baseline; SII, systemic immune-inflammation index; IFA, semiquantitative direct immunofluorescence analysis of renal biopsy samples; IgG, immunoglobulin G; C3, complement C3.

Table 4 Characteristics of Patients with a 50% or More Cr Increase

Characteristic	Patients with Cr Increase n=7	Other Patients n=111	P value
Gender (male/female)	7/0	63/48	0.040^a
Age (years)	59.0 (37.0–66.0)	55.0 (47.0–61.0)	0.686
PLA2R Ab (±)	5/2	70/41	1.000
PLA2R Ab titer (RU/mL)	88.34 (0.00–151.66)	51.78 (0.00–164.92)	0.653
UTP (g)	5.15 (2.81–8.12)	3.71 (2.00–5.36)	0.356
ALB (g/L)	18.4 (16.7–35.2)	24.5 (20.5–28.2)	0.245
Cr (µmol/L)	95.8 (69.1–123.0)	65.4 (56.5–77.2)	0.024^a
Neutrophil (×10^9/L)	4.69 (2.89–7.44)	3.77 (3.26–4.82)	0.319
Lymphocyte (×10^9/L)	1.98 (1.34–2.40)	2.03 (1.54–2.53)	0.536
Monocyte (×10^9/L)	0.41 (0.29–0.74)	0.35 (0.28–0.44)	0.814
Platelet (×10^9/L)	238.00 (209.00–313.00)	241.00 (204.00–280.00)	0.181
NLR	2.96 (1.79–3.50)	1.99 (1.48–2.66)	0.087
MLR	0.26 (0.22–0.31)	0.18 (0.13–0.22)	0.012^a
PLR	130.42 (121.51–178.33)	118.25 (90.00–160.34)	0.390
SII	756.00 (315.93–1266.17)	471.59 (351.43–663.08)	0.181
IgG IFA	3.0 (3.0–4.0)	3.0 (3.0–4.0)	0.892
C3 IFA	2.0 (1.0–3.0)	1.5 (1.0–2.1)	0.640
Immunosuppressive therapy (yes/no)	6/1	83/28	0.824
Improved ALB at 6 months (yes/no)	2/5	76/35	0.044^a
CR at the end of follow-up (yes/no)	0/7	73/36	0.001^b

Note: ^aP<0.05; ^bP<0.01.

Abbreviations: PLA2R Ab, PLA2R Ab qualitative test; UTP, 24-h urinary protein at baseline; ALB, serum albumin at baseline; Cr, serum creatinine at baseline; Neutrophil, peripheral blood neutrophil count; Lymphocyte, peripheral blood lymphocyte count; Monocyte, peripheral blood monocyte count; Platelet, peripheral blood platelet count; NLR, neutrophil–lymphocyte ratio; MLR, monocyte–lymphocyte ratio; PLR, platelet-to-lymphocyte ratio at baseline; SII, systemic immune-inflammation index; IFA, semiquantitative direct immunofluorescence analysis of renal biopsy samples; IgG, immunoglobulin G; C3, complement C3; CR, complete remission.

Figure 2 Receiver operating characteristic (ROC) curves showing the sensitivity and specificity of MLR and Cr at renal biopsy for renal outcomes. MLR had the larger area under the curve (AUC=0.784) than Cr (AUC=0.754).

Abbreviations: MLR, monocyte–lymphocyte ratio; Cr0, serum creatinine at baseline.