Association of neutrophil-to-lymphocyte ratio with renal impairment among patients with acute gouty arthritis

Int Urol Nephrol. 2022 Nov;54(11):2995-3000. doi: 10.1007/s11255-022-03239-9. Epub 2022 May 25.

Abstract

Objective: Gouty arthritis (GA) is an inflammatory disease, and renal impairment may occur to varying degrees with the progress of disease. The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker. In this study, we aimed to explore the association between NLR and renal impairment in GA.

Materials and methods: The subjects comprised 499 patients with gouty arthritis (GA) (473 men, 26 women; age range, 39-61 years old) from our hospital. They were divided into a chronic kidney disease (CKD) group (n = 206) and non-CKD group (n = 293) according to the glomerular filtration rate. Blood samples were collected during the gout flares. The differences in NLR, general data, and laboratory indexes of patients with GA between the two groups were compared, such as serum uric acid (SUA), serum creatinine (SCREA), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), high-density lipoprotein (HDL), and low-density lipoprotein (LDL).

Results: NLR (3.38 vs. 2.38 (p < 0.001)) was higher in the CKD group, compared to the non-CKD group. Similarly, both SUA (527 vs. 507 (p < 0.05)) and SCREA (122 vs. 87 (p < 0.001)) were higher in the CKD group than in the non-CKD group. Multivariate logistic regression analysis showed that NLR (OR = 1.122, p < 0.05), age, hypertension, and SUA were risk factors for CKD in patients with GA, although HDL and HGB were protective factors. The receiver operating characteristic (ROC) curve analysis indicated that the area under the curve of NLR for predicting CKD in patients with GA was 0.646 (95% CI 0.597-0.694).

Conclusion: Our data showed that NLR might be an important potential factor for evaluating renal impairment in GA during flares.

Keywords: Chronic kidney disease; Gouty arthritis; Neutrophil-to-lymphocyte ratio; Serum uric acid.

MeSH terms

  • Adult
  • Arthritis, Gouty* / complications
  • Biomarkers
  • C-Reactive Protein / analysis
  • Creatinine
  • Female
  • Humans
  • Lipoproteins, HDL
  • Lipoproteins, LDL
  • Lymphocytes / chemistry
  • Male
  • Middle Aged
  • Neutrophils
  • Renal Insufficiency, Chronic*
  • Retrospective Studies
  • Uric Acid

Substances

  • Biomarkers
  • Lipoproteins, HDL
  • Lipoproteins, LDL
  • Uric Acid
  • C-Reactive Protein
  • Creatinine