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Shedding Light on NLR Dynamics: A Journey Through CKD Stages

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Abstract

Background

Chronic kidney disease (CKD) being a gradually progressive disease involves declining renal function and systemic inflammation. The neutrophil-to-lymphocyte ratio (NLR), an emerging inflammatory marker, may serve as a valuable indicator of CKD severity and progression. The aim of this retrospective cross-sectional study was to investigate the association and variability of NLR across the stages of CKD.

Methods

The study took place at the Multan Institute of Kidney Diseases using data from the hospital's electronic records. The study duration was six months, from November 2022 to April 2023. CKD stages were assessed, and NLR was calculated. Statistical analysis was done to investigate the relationship between NLR and the different stages of CKD.

Results

The mean age of patients was 49 ± 16.9 years, out of which more than half were males. A statistically significant relationship (P-value < 0.05) was found between the NLR and disease severity across five stages of CKD. Additionally, the analysis of mean NLR values between different CKD stages indicated significant differences in NLR between Stage 5 and the other stages.

Conclusion

NLR is independently associated with CKD stage and may serve as a useful biomarker for assessing disease severity, particularly in advanced CKD. In resource-limited settings, NLR could facilitate risk stratification and support clinical decision-making for CKD patients.

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Data Availability

No datasets were generated or analysed during the current study.

Code Availability

Not applicable.

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Acknowledgements

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Funding

No funding or sponsorship was involved in this study.

Author information

Authors and Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Z.R., A.T., M.Z. and F.Z.T. The first draft of the manuscript was written by Z.R. and A.T., and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zoha Rasool.

Ethics declarations

Ethics Approval

The study performed involving human participants was in accordance with the ethical standards of the Ethical Review Committee of Indus Hospital and Health Network (IHHN_IRB_2023_05_038) at which the study was conducted and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent for Publication

Data was anonymized, written consent for publication was waived.

Consent to Participate

The study was granted informed consent waiver due to its retrospective nature.

Competing interests

The authors declare no competing interests.

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Rasool, Z., Tasneem, A., Zubair, M. et al. Shedding Light on NLR Dynamics: A Journey Through CKD Stages. SN Compr. Clin. Med. 7, 297 (2025). https://doi.org/10.1007/s42399-025-02066-0

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  • DOI: https://doi.org/10.1007/s42399-025-02066-0

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