Abstract

Hematological Alterations in Chronic Kidney Disease of Humans and Animals and Evaluation of its Inflammatory and Hematological Markers

Authors: Usman Ali, Sidra Muhyuddin, Adeel Hassan, Ali Raza Saleem, Asma Sahar, Muhammad Sami Hassaan, Haseeb Ullah, Atiq Ullah, Naushad Ullah, Ramisha Qaiser, Qamar Abbas, Hamza khalid and Muhammad Kashif Khan

DOI: http://dx.doi.org/10.71081/cvj/2025.044

Abstract
Chronic Kidney Disease (CKD) is a long-term condition characterized by lasting structural or functional damage to the kidneys for a duration exceeding three months. It is linked to a shortened lifespan and a heightened likelihood of developing cardiovascular diseases, anemia, infection, and certain types of cancers in humans and animals. Recent studies have highlighted the inflammatory markers such as the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as potential tools for predicting the progression and mortality risk in chronic kidney disease (CKD). However, their significance in patients with CKD who have not yet begun dialysis remains unclear. This study aimed to examine the association between NLR, PLR and systemic inflammation in non-dialysis CKD patients. A cross-sectional analysis was carried out at the Multan Institute of Kidney Disease in Multan, Pakistan between April and August 2024. The study involved 156 individuals with CKD and 25 healthy male participants as a control group. Information on demographics, clinical profiles such as blood pressure, Body Mass Index (BMI) and coexisting conditions was gathered. Blood tests were conducted to assess complete blood count, serum creatinine, albumin, C-reactive protein (CRP) and other relevant parameters. NLR and PLR were derived from hematological values while CKD diagnosis was based on estimated glomerular filtration rate (eGFR) calculated through the MDRD4 equation along with evidence of albuminuria. Data analysis was performed using SPSS version 21 with p value less than 0.05 revealed significantly higher NLR and PLR levels in CKD patients versus controls, which indicating the elevated inflammation. Both markers are negatively correlated with eGFR and positively with CRP and albuminuria. Anemia is a normocytic type and it was common among CKD patients. NLR and PLR emerged as reliable and low cost indicators of systemic inflammation. These markers may aid in tracking disease progression in non-dialysis CKD. Their use could improve the early detection and management of CKD complications.

Keywords: Albuminuria, Chronic Kidney Disease (CKD), Neutrophil-to-Lymphocyte Ratio (NLR), Non-Dialysis Patients, Platelet-to-Lymphocyte Ratio (PLR), Systemic Inflammation