The Inflammatory Role of the Neutrophil Platelet Ratio in Health, Hypertension and Chronic Kidney Disease The Inflammatory Role of the Neutrophil Platelet Ratio.

Abstract

Background: Inflammation is a known associate and accelerator of kidney disease. Both are associated with changes in the hemogram, particularly elevated neutrophils and platelets counts, in association with reductions in the lymphocyte count.

Methods: The data of 298 participants (146 healthy, 94 hypertensives, and 58 with CKD) was studied, and the associations between the neutrophil platelet ratio (NPR) and urinary, and serum indices of kidney function in health, hypertension and CKD were accessed.

Results: The participants mean age was 54.91± 64 years; the CKD cohorts were older, p<0.0001. The blood pressures and urine albumin creatinine ratio (UACR) were higher in the elderly. The absolute neutrophil count was higher in hypertension than CKD (p<0.001), and the platelet count was higher in CKD than hypertension (p<0.001). The neutrophil platelet ratio (NPR) was significantly higher in hypertension than CKD (p=0.02) and in males than females, p=0.007. The NPR had a stronger negative correlation with the UACR and glomerular filtration rate (GFR) in hypertension than CKD. Elevated NPR was associated with advancing age (p<0.001), female gender (p<0.001), hypertension (p<0.001), elevated absolute neutrophil count (ANC) (p<0.001), elevated UACR (p=0.01), higher GFR (p<0.001) and reduced kidney volume (p=0.02). Only hypertension (OR-2.93, 95% CI-2.15-9.48) and ANC (OR-2.14, 95% CI- 1.96-5.07) were independent associates of elevated NPR.

Conclusion: The NPR was higher in hypertension than CKD, it tended to be an inflammatory marker in hypertension but as an anti-inflammatory marker in CKD. Future studies involving multi-racial populations are needed to ascertain the definitive inflammatory (or otherwise) role of the NPR in kidney disease.