DOI: 10.4103/injms.injms_165_26 ISSN: 0976-2884

Study of Neutrophil–Lymphocyte Ratio and Platelet–Lymphocyte Ratio in Patients with Diabetic Nephropathy

Vaibhav Shukla, Amandeep Malik, Abhishek Singh, Ansh Srivastav

Abstract

Introduction:

Diabetic nephropathy (DN), a leading cause of end-stage renal disease in patients with type 2 diabetes mellitus (T2DM), is characterized by progressive renal impairment and chronic inflammation. Identifying simple, reliable, and cost-effective biomarkers for early detection and monitoring of DN is essential. This study investigates the utility of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as inflammatory markers in DN.

Materials and Methods:

A cross-sectional, case–control study was conducted at a tertiary care hospital in Lucknow over 24 months. A total of 86 T2DM patients were enrolled, with 43 patients having DN (cases) and 43 without DN (controls), classified based on urinary albumin-to-creatinine ratio as per KDIGO 2012 guidelines. Clinical, anthropometric, and laboratory parameters were assessed, and NLR and PLR were calculated from complete blood counts. Statistical analysis included t -tests, Pearson’s correlation, and receiver operating characteristic (ROC) curve analysis.

Results:

NLR and PLR were significantly elevated in patients with DN (NLR: 7.16 ± 7.24; PLR: 11.65 ± 6.33) compared to controls (NLR: 3.44 ± 3.15; PLR: 8.45 ± 6.70) with P = 0.003 and 0.026, respectively. ROC analysis showed NLR had greater diagnostic accuracy (area under the ROC [AUROC] = 0.759) than PLR (AUROC = 0.685). Patients with DN also exhibited higher body mass index, poorer glycemic control (elevated FBS and PPBS), lower hemoglobin levels, and higher urea and creatinine values.

Conclusion:

NLR and PLR are significantly associated with DN and may serve as accessible, cost-effective biomarkers for its early detection. Among them, NLR demonstrated superior diagnostic performance. Further prospective studies are needed to validate their clinical application and define standardized cutoff values.

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