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Neutrophil–lymphocyte count ratio as a diagnostic marker for acute kidney injury: a systematic review and meta-analysis

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Abstract

Background

The neutrophil-to-lymphocyte ratio (NLR) is calculated from the white cell differential blood count. Recently, NLR was identified as a potential biomarker for the prediction of acute kidney injury (AKI). We conducted this systematic review and meta-analysis to evaluate the diagnostic value of NLCR for AKI in adult patients.

Methods

Studies in the PubMed, EMBASE, Web of Science and Cochrane Library databases were systematically searched from the date of database inception to February 28, 2019. The predictive value of NLR for AKI was evaluated by the pooled sensitivity, specificity, and summary receiver operating characteristic curve (SROC) analyses. Review Manager and Stata were used for all statistical analyses. The sources of potential heterogeneity were explored by a sensitivity analysis and subgroup analysis.

Results

This meta-analysis returned 89 reports, of which 9 fulfilled the inclusion criteria, accounting for 9766 patients. Bivariate analysis yielded a mean sensitivity of 0.736 (95% CI 0.675–0.790) and specificity of 0.686 (95% CI 0.601–0.759). The SROC was 0.77 (95% CI 0.74–0.81). The studies had no significant heterogeneity (Q = 0.675, p = 0.357, I2 = 0).

Conclusions

Our findings indicate that the NLR may be a reliable biomarker for the early detection of AKI. Our findings also provide important information and assistance for clinicians in the prediction of AKI.

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Author information

JG designed and supervised the study, gathered some data and conducted a rigorous review of the final version of the manuscript. DC performed the statistical analyses, and drafted the manuscript. DX, BC helped to acquire the data and assessed the risk of bias of the trials. ZGW helped to draft the manuscript and interpret the data. All authors read and approved the final manuscript.

Correspondence to Junchuan Guo.

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All the authors declare no conflict of interest in this work.

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Cite this article

Chen, D., Xiao, D., Guo, J. et al. Neutrophil–lymphocyte count ratio as a diagnostic marker for acute kidney injury: a systematic review and meta-analysis. Clin Exp Nephrol 24, 126–135 (2020). https://doi.org/10.1007/s10157-019-01800-y

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Keywords

  • Neutrophil-to-lymphocyte ratio
  • Acute kidney Injury
  • Biomarker
  • Diagnosis
  • Meta-analysis