Gnanamoorthy Kothai1 , Kumaravel Neha2 , Aruna Bholenath Patil3 , Athanallur Raman Malathy4 , Suthakaran Prasanna Karthik5
BACKGROUND Diabetic Nephropathy is a potentially serious complication of diabetic mellitus which can lead to renal failure. This is manifested as increased urinary albumin excretion ranging from microalbuminuria to overt macroalbuminuria and eventually end stage renal failure. Most of the current tests can identify the condition only after the damage to the kidney has occurred. Thus, there is a need for early predictors of diabetic nephropathy which are cheap and easily accessible to the population in a resource constrained country like India. Neutrophil Lymphocyte Ratio (NLR) is one such test which was evaluated for its identification of diabetic nephropathy. METHODS 127 diabetic patients attending a tertiary care center were enrolled in this cross sectional prospective observational study. Glycaemic indices and neutrophil lymphocyte ratio were estimated, and statistical analysis was done. RESULTS The mean eGFR of the study population was 91.6 ± 48.7 mL/min. The mean protein creatinine ratio (PCR) was 0.8 ± 0.4. Correlation analysis revealed a strong positive correlation between the urinary PCR and NLR which was also statistically significant (r = 0.813, p <0.0001). NLR cut off of 7 had a sensitivity and specificity of 88.89% and 94.9% respectively with a positive likelihood ratio of 17.481 and a negative likelihood ratio of 0.117. CONCLUSIONS NLR is a simple, easily available and cost effective investigation which can be used as a screening tool to detect diabetic nephropathy at an earlier stage.
