Association of serum markers of iron status with Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in chronic kidney disease patients undergoing Hemodialysis

Background & objectives: Chronic kidney disease (CKD) is a major health issue worldwide which leads to end stage renal failure and cardiovascular events. Anemia in CKD patients is highly prevalent, the commonest one being iron deficiency anemia (IDA). Anemia leads to reduction in quality of life and cardiovascular performance and increased rate of hospitalization and mortality. Hematological indices such as Neutrophil-lymphocyte ratio (NLR) and Platelet lymphocyte ratio (PLR) are markers for systemic inflammation. We aimed to explore the association serum markers of iron status with NLR and PLR in CKD patients on Hemodialysis attending AMCH. Method This was a hospital-based cross-sectional study done on 74 adult CKD patients from the department of Nephrology ward and Dialysis ward. Iron profile was analyzed on Dimension® RxL Max clinical chemistry, CLIA (SIEMENS ADVIA Centaur® CP)and hematological parameters were analyzed on Coulter counter (HORIBA Yumizen H2500). Data were analyzed using SPSS version 20. Result The mean age of study population was 48.89 ± 15.92years.Seventy two (97.3%) had anemia. 56.8% had absolute iron deficiency, whereas the remaining 43.2% had functional iron deficiency. NLR had significant positive correlations with CRP and ferritin, but non-significant correlations with other parameters of iron profile. PLR was positively correlated with CRP, but had negative correlations with all other iron profile parameters. Interpretations & Conclusions: Anemia is highly prevalent among CKD patients, with almost similar proportions of absolute and functional iron deficiency based on iron profile parameters. NLR and PLR are cheaper and reliable markers that correlate well with CRP and ferritin.