Can neutrophil–lymphocyte ratio be independent risk factor for predicting acute kidney injury in patients with severe sepsis?

Figures & data

Table 1. Patients’ characteristics and clinical outcome.

Characteristic	Group 1 [AKI, n = 68]	Group 2 [No AKI, n = 50]	p-Value
Age, years	63.7 ± 12.2	54 ± 9.8	<0.001
Gender (male), n (%)	35 (51.4)	25 (50)	0.823
BMI, kg/m^2	28.7 ± 4.5	28.4 ± 4.9	0.853
Smoking history, n (%)	22 (32.3)	15 (30)	0.192
Hypertension, n (%)	40 (58.8)	28 (56.0)	0.318
Diabetes mellitus, n (%)	17 (25)	12 (24)	0.427
Congestive heart failure, n (%)	6 (8.8)	4 (8.0)	0.765
COPD, n (%)	13 (19.1)	9 (18.0)	0.538
ACE/ARB, n (%)	38 (55.8)	23 (46.0)	0.091
Source of infection
Lung, n (%)	24 (35.2)	17 (34.0)	0.806
Urinary tract, n (%)	16 (23.5)	11 (22.0)	0.742
Intra-abdominal, n (%)	9 (13.2)	6 (12.0)	0.527
Other, n (%)	19 (28.1)	16 (32.0)	0.106
Baseline APACHEII	23.6 ± 4.5	21.9 ± 4.8	0.151
Baseline global SOFA score	11.2 ± 3.9	10.1 ± 3.2	0.176
Baseline invasive mechanical ventilation status, n (%)	24 (35.2)	16 (32)	0.095
Duration of invasive mechanical ventilation, h	122 (98)	117 (101)	0.134
On admission laboratory values
Creatinine level, mg/dL	0.95 ± 0.24	0.91 ± 0.20	0.679
International normalized ratio	1.2 ± 0.7	1.3 ± 0.8	0.518
aPTT, s	45 (35)	42 (31)	0.387
ALT, U/L	51 ± 32	55 ± 35	0.412
AST, U/L	56 ± 40	53 ± 42	0.527
Total bilirubin, mg/dL	1.7 ± 0.9	1.6 ± 0.8	0.719
Calcium, mg/dL	9.1 ± 0.5	9.2 ± 0.6	0.847
Na, mEq/L	140 ± 4.4	139.5 ± 4.8	0.761
K, mEq/L	4.46 ± 0.85	4.38 ± 0.90	0.793
Albumin, g/dL	3.78 ± 0.42	3.71 ± 0.46	0.649
Uric acid, mg/dL	6.3 ± 1.1	6.2 ± 1.2	0.871
CRP, mg/L	345 (205)	339 (197)	0.574
Platelet count, × 10^9/L	96.4 (132)	93.2 (151)	0.692
WBC, ×10^3/mm^3	16.7 ± 5.4	15.9 ± 5.6	0.310
NLR	13.56 ± 4.39	7.83 ± 2.45	<0.001

Table 2. Risk factors for development of AKI in patients with severe sepsis: multiple logistic regression analysis.

	OR (95% CI)	p-Value
Age	1.127 (1.062–1.325)	0.271
APACHE II	1.72 (1.61–1.92)	0.038
NLR	3.25 (2.72–4.19)	<0.001
Use of ACE or ARB	1.052 (1.038–1.087)	0.756
Duration of invasive mechanical  ventilation, per one hour	1.28 (1.07–1.41)	0.048
Global SOFA score	1.022 (1.011–1.049)	0.861

Figure 1. ROC curves showed that best cut-off value of NLR for prediction of sepsis-related-AKI.

Table 3. Threshold levels, sensitivity and specificity of WBC, CRP and NLR levels for predicting AKI development.

	Threshold value	Sensitivity	Specificity	AUC	p-Value
WBC (×10^3/mm^3)				0.463	0.55
CRP (mg/L)				0.531	0.18
NLR	10.15	0.902	0.929	0.951	0.001