Elevated neutrophil-lymphocyte ratioand delayed graft function

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Itzy Maely Gaytán-Campos https://orcid.org/0009-0000-5720-4774
Aurelio Chávez-Meza https://orcid.org/0009-0009-5764-7626
José Oscar Juárez-Sánchez https://orcid.org/0000-0002-3560-7879
Yumar Alfredo Hurtado-Castillo https://orcid.org/0009-0007-4479-4251
Rafael Luna-Montalbán https://orcid.org/0000-0002-2411-7524
Martha Alicia Hernández-González https://orcid.org/0000-0002-6903-2233

Keywords

Kidney Transplantation, Acute Kidney Injury, Neutrophils, Tissue Donors

Abstract

Background: Delayed graft function (DGF) is a significant complication in kidney transplantation, adversely affecting graft and recipient survival. Therefore, it is important to establish tools that help predict this condition. The elevation of the neutrophil-to-lymphocyte ratio (NLR) has been studied as a predictor of DGF, with the premise that its increase is associated with systemic inflammation and, consequently, DGF.


Objective: To analyze the association between an elevated NLR in the preoperative period and delayed graft function in kidney transplant recipients.


Materials and methods: A prospective, observational, analytical, and longitudinal study. The sample included all patients admitted to the Nephrology Transplant Service at Hospital de Especialidades No. 1, Centro Médico Nacional Bajío, in 2023.


Results: We found that an NLR greater than 3.5 in the preoperative period of patients undergoing kidney trans[1]plantation had 80% specificity and 28% sensitivity, compared to patients with an NLR of 3.5 or lower.


Conclusions: There is no association between an elevated NLR in the preoperative period and delayed kidney graft function after transplantation. However, it may be associated with other risk factors, as demonstrated in the multivariate analysis, which revealed that donor acute kidney injury increased the likelihood of developing DGF by almost 200%.

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