Turkish Journal of Nephrology
Original Article

Examining the Relationship between “Neutrophil-to-Lymphocyte Ratio” and Peripheral Blood Inflammatory Factors in the Patients Undergoing Chronic Dialysis


Chronic Kidney Disease Research Center (CKDRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran


Department of Nephrology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Student Research Committee, Chronic Kidney Disease Research Center (CKDRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran


Tropical and Infectious Disease Center, Medical University of Kordestan, Kordestan, Iran

Turkish J Nephrol 2023; 32: 296-303
DOI: 10.5152/turkjnephrol.2023.22363
Read: 447 Downloads: 295 Published: 29 September 2023

Objective: Neutrophil-to-lymphocyte ratio has been considered an inflammatory prognostic factor in end stage kidney disease patients. Since access to laboratory kits has often been difficult and costly for inflammatory factors, such as tumor necrosis factor-alpha and interleukin 6, neutrophil to lymphocyte ratio, if proven, can be a helpful alternative. Thus, we aimed to determine the relationship between neutrophil-to-lymphocyte ratio and other inflammatory factors and their roles in the prognosis of dialysis patients.

Methods: In this prospective study, 70 adult dialysis patients were enrolled. The checklist contains patient information, including age, sex, duration, and onset of dialysis, the leading cause of ESKD, type of dialysis access, arterial blood pressure, and biochemical factors such as CRP, ESR, interleukin 6, tumor necrosis factor-alpha, and so on. Neutrophil-to-lymphocyte ratio was obtained from neutrophil fractionation to lymphocyte.

Results: The results of this study indicated that interleukin 6 levels had a direct and significant relationship with neutrophil-to-lymphocyte ratio (P < .001). Also, linear regression analysis showed a direct and significant relationship between interleukin 6 and neutrophil-to-lymphocyte ratio (P< .0001, t = 2.874, and beta = 0.278), while controlling the effect of confounding variables. Only interleukin 6 was significantly higher in the neutrophil-to-lymphocyte ratio >  2.5 group (P < .0001). However, interleukin 6 and tumor necrosis factor-alpha had no significant correlation with the crude number of lymphocytes and neutrophils.

Conclusion: In this study, we showed that higher levels of neutrophil-to-lymphocyte ratio in dialysis patients are associated with age and elevated levels of calcium, interleukin 6 and CRP, and serum ferritin, suggesting a high level of inflammation in these patients.

Cite this article as: Samadian F, Sigari N, Ashrafi S, Farzinpoor Z, Dalili N. Examining the relationship between “neutrophil-to-lymphocyte ratio” and peripheral blood inflammatory factors in the patients undergoing chronic dialysis. Turk J Nephrol. 2023;32(4):296-303.

EISSN 2667-4440