High neutrophil to lymphocyte ratio predicts acute allograft rejection in kidney transplantation; a retrospective study

ABSTRACT

Background/aim: Our research focused on the identification of easily available and sensitive markers for early prediction of acute kidney allograft rejection (AR). We aimed to investigate the association between neutrophil-to-lymphocyte ratio (NLR) and AR in kidney transplant patients. Materials and methods: The medical records of 51 kidney transplant patients [12 female/39 male; median age of 32 (IQR 24­44) years] were evaluated retrospectively. We considered a cut-off value of >2.5 as high NLR. Results: A total of 22 biopsy-proven AR patients and 29 controls were evaluated. The AR group had a higher NLR compared to the controls (P < 0.001). NLR levels over 2.5 [95% CI 54.88 (9.96­302.3), P < 0.001] were significantly associated with AR in univariate analysis. The NLR levels were the only significant factor associated with AR in multivariate models, in model 1 (adjusted by age and sex) [95% CI 114 (11.1­1175), P < 0.001], and in model 2 (adjusted by steroid dosage, uric acid, and NLR) [95% CI 4.60 (1.59­29.3), P = 0.004]. Conclusions: Our data showed that higher NLR values (>2.5) are associated with AR in kidney transplant patients, leading to the conclusion that NLR might be an easily available and useful marker option for detection of AR in this patient population.