The effect of neutrophil/lymphocyte and platelet/lymphocyte ratios on disease prognosis in patients with membranous nephropathy

The most common cause of adult nephrotic syndrome is membranous nephropathy (MN). Several factors have been identified to evaluate the prognosis of MN. Male gender, Asian ethnicity, advanced age, low initial renal function, high degree of proteinuria, high urinary excretion of IgG and α-1 microglobulin, and glomerular segmental sclerosis are poor prognostic factors. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are currently used as indicators of systemic inflammation. There is limited literature on the impact of NLR and PLR on the prognosis of patients with primary MN. In this study, we aimed to evaluate the effect of NLR and PLR on the prognosis of primary MN patients during a 5-year follow-up period. Additionally, the impact of sociodemographic and biochemical values on prognosis was evaluated. Data on sociodemographic, biochemical, and hemogram values of 75 primary MN patients from two different hospitals were collected retrospectively for a 60-month follow-up period. The prognostic effect of NLR and PLR at the time of diagnosis on proteinuria improvement, risk level, progression to end-stage renal disease (eGFR<15mL/min/1.73m2), and deterioration of renal function (eGFR<60mL/min/1.73m2) was evaluated at 6 and 12 months. NLR and PLR did not have a prognostic effect on proteinuria improvement, and there was no significant difference in NLR and PLR levels among risk groups. However, high creatinine levels, low hemoglobin levels, high NLR, and high PLR at the time of diagnosis had a poor prognostic effect on progression to end-stage renal disease, while high creatinine levels, low hemoglobin levels, and high NLR had a poor prognostic effect on the deterioration of renal function. No statistically significant threshold values were found for NLR and PLR to predict progression to end-stage renal disease and deterioration of renal function. In conclusion, NLR and PLR are inexpensive and easily accessible values that can be used as prognostic markers in patients with primary MN. Further studies with larger samples and comprehensive analyses will provide a clearer understanding of the role of NLR and PLR in primary MN.