Study of neutrophil lymphocyte ratio as indicator of nephropathy in type 2 diabetes mellitus

Background: Diabetic nephropathy is the leading cause of chronic kidney disease (CKD). However, the degree of albuminuria is not necessarily linked to disease progression in patients with DN. Several studies that have explored the relationship between systemic inflammation and vascular disease. Neutrophil-Lymphocyte ratio (NLR) may be considered as a marker of chronic inflammation. Methods: This was a cross sectional study which was conducted in Sardar patel medical college and associated group of hospital, Bikaner from November 2016 to October 2018 over 303 type 2 diabetes mellitus patient who fulfill inclusion and exclusion criteria. NLR was calculated by analyzing differential leukocyte count in complete blood picture. Albuminuria was detected by CHEMSTRIX-AG TEST STRIP by dipstick method. Results: Out of 303 patient 168 cases had their urine albumin positive while 135 cases had urine albumin Nil. when both group compare for complete blood count parameter haemoglobin had a non significant (p>0.05) relation with urine albumin while TLC, Neutrophil, ANC, Lymhocyte, ALC and NLR had a highly significant (p<0.001). In present study, mean NLR in normoalbuminuria was 1.720.49 and for microalbuminuria it was 2.430.57 (p<0.001). Conclusion: Microalbuminuria was found to be one of the earliest marker for DN. However, recent studies have shown that albuminuria is a less precise predictor of overt nephropathy risk than originally thought. . The results of our study have shown that there was a significant relation between NLR and DN. NLR is a simple, inexpensive test. Therefore, NLR may be considered as a predictor and a prognostic risk marker of DN.