Diabetic nephropathy is a major concern for patients with diabetes and pre-diabetes. The neutrophil-lymphocyte ratio (NLR) in kidneys has prognostic value for cancers and diabetes, and may have utility as a predictor of kidney function decline. In this cohort study, investigators measured the NLR for 3112 individuals with diabetes and pre-diabetes and followed up their kidney function in order to examine the effect between NLR and estimated glomerular filtration rate (eGFR) decline, renal function decline (RFD), and chronic kidney disease (CKD). Investigators found that the incidence of rapid eGFR decline, RFD, and CKD over 3.3 years were 12.95%, 4.34%, and 1.57% respectively. Linear regression models showed that each unit increase in NLR was associated with a 29% (HR 1.29, 95% CI 1.14 to 1.45) increase in risk of rapid eGFR decline, a 33% (HR 1.33, 95% CI 1.09 to 1.63) increase in risk of RFD, and 69% (HR 1.69, 95% CI 1.21 to 2.38) increase in risk of CKD. The tertile of patients with the highest NLRs had higher risks of eGFR decline (HR 1.66, 95% CI 1.29 to 2.14), RFD (HR 1.58, 95% CI 1.02 to 2.46), and CKD (HR 2.29, 95% CI 1.00 to 5.21) compared to the tertile with the lowest NLRs. Overall, results from this study indicate that NLR may be an independent predictive factor for kidney function decline in patients with diabetes and pre-diabetes.
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