Correlation Analysis Of Neutrophil-lymphocyte Ratio And Renal Function Impairment In Patients With Heart Failure

Objective: Many patients with heart failure suffer different degrees of kidney dysfunction.Studies suggest that both congestive heart failure(CHF)and chronic kidney disease(CKD)are associated with inflammatory activation.The neutrophil-lymphocyte ratio(NLR)has become a simple and effective indicator of systemic inflammatory response.The objective of this study was to investigate the relationship between NLR and renal function related parameters in patients with chronic heart failure.Methods: A total of 254 patients with heart failure without infection or chronic inflammation treated in the First Hospital of Hebei Medical University from January 2018 to July 2019 were selected.The basic characteristics,clinical symptoms and signs,echocardiographic parameters and some laboratory indicators of the patients were reviewed.The patients were divided into 108 patients with ejection fraction retention heart failure(HFp EF),42 patients with median ejection fraction retention heart failure(HFmr EF)and104 patients with reduced ejection fraction heart failure(HFrEF).We analyzed the correlation between NLR and renal function parameters.Correlations between other inflammatory markers,such as white blood cell count(WBC),C-reactive protein(CRP),neutrophils,lymphocytes,and renal function parameters were also analyzed.The renal function parameters included creatinine(Cr),urea,and uric acid(UA),and the glomerular filtration rate(eGFR)was calculated using a simplified MDRD formula.WBC count,neutrophils count,lymphocyte count and NLR had no significant correlation with UA.Results:NLR was significantly positively correlated with Cr(r=0.360,P<0.01)and negatively correlated with eGFR(r=-0.398,P <0.01),but not with urea or UA in patients with chronic heart failure without infection or chronic inflammation.Meanwhile,CRP was positively correlated with UA(r=0.156,P<0.05),neutrophil count was positively correlated with Cr(r=0.209,P<0.01),and negatively correlated with eGFR(r=-0.136,P<0.05).On the contrary,lymphocyte count was negatively correlated with Cr(r=-0.278,P <0.01)and positively correlated with eGFR(r=0.349,P<0.01).WBC count,neutrophils count and lymphocyte count had no significant correlation with UA.Conclusions: Elevated NLR was significantly associated with abnormal renal function in patients with chronic heart failure without infection or chronic inflammation.However,since this was an observational study,further studies are needed to confirm our results.