Red Cell Distribution Width and Neutrophil-Lymphocyte Ratio as Markers for Diabetic Nephropathy
doi.org/10.26538/tjnpr/v4i8.3
Keywords:
ROC curve, Neutrophil-lymphocyte ratio, Red cell distribution width, Diabetic nephropathyAbstract
Diabetic nephropathy (DN) is the foremost cause of end-stage renal disease. Early detection of DN can spare diabetic patients of severe complications. This study aimed to evaluate the diagnostic value of red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) in the detection of DN in patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included a total of 130 patients with T2DM, already diagnosed with T2DM. The albumin creatinine ratio (ACR) in urine samples was calculated for each patient, according to which patients were divided into two groups: with evidence of DN when ACR ≥ 30 mg/g, and those with no evidence of DN when ACR < 30 mg/g. According to multivariate analysis, each of disease duration (OR = 4.43, 95% CI = 1.68-11.68, p = 0.003), HbA1c (OR = 6.4, 95% CI = 2.32-17.65, p < 0.001) and NLR (OR = 13.75, 95% CI = 1.68-11.68, p < 0.001) were independent predictors for DN. Using the receiver operating characteristic (ROC) curve to evaluate the diagnostic value of NLR revealed that the AUC was 0.736 (95% CI = 0.635-0.837), p < 0.001. The sensitivity and specificity of the test at the cut-off value of NLR = 3.35 was 69% and 89%, respectively. These data indicate that NLR is a simple non-expensive test that can be used regularly to investigate diabetic patients for the development of DN. Red cell distribution width (RDW), on the other hand, had no diagnostic value in this regard.
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