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Role of neutrophil-lymphocyte ratio as a prognostic marker for type 2 diabetic nephropathy among Indians



Murugan Subramani1, Mudali Anbarasan1, Shanmugam Deepalatha2, Lakshmi Narayanan Muthumani1* & Pradeep Vasudevan1



1Department of General Medicine, K.A.P Viswanatham Govt Medical College, Trichy 17; 2Department of Microbiology, Thanjavur Medical College, Thanjavur, India; *Corresponding author



Murugan Subramani - drsubbu1976@gmail.com.

Mudali Anbarasan - anbarasanmudali@gmail.com.

Shanmugam Deepalatha - drdeepamani@gmail.com.

Lakshmi Narayanan Muthumani - drmuthumani@yahoo.co.in

Pradeep Vasudevan - vprad1993eepdr26@gmail.com


Article Type

Research Article



Received April 1, 2023; Revised April 30, 2023; Accepted April 30, 2023, Published April 30, 2023



Diabetic nephropathy/diabetic kidney disease (DKD) is one of the leading causes of renal failure. Early identification of the development or progression of diabetic nephropathy using appropriate screening and diagnostic tools is very important in order to provide timely and proper management. Inflammation plays a crucial role in development and progression of diabetic nephropathy. The aim of this study was to evaluate the relationship of inflammatory markers (neutrophil-to-lymphocyte ratio-NLR) as an early indicator to prevent the progression of diabetic kidney disease. A total of 158 patients with type 2 diabetes mellitus were distributed into three groups according urinary albumin-to-creatinine ratio. Levels of inflammatory markers neutrophil-to-lymphocyte ratio was recorded and compared among the three groups. Significant differences were detected between the groups in terms of neutrophil-to-lymphocyte ratio (p = 0.000).Characteristic curve analysis of inflammatory markers and microalbuminuria prediction demonstrated an area under curve (AUC) of 0.869 for neutrophil-to-lymphocyte ratio (p = 0.000). A NLR cut-off point of 2.2 has 72.3 % sensitivity and 78.1 % specificity, which suggested sufficient accuracy. Increased neutrophil-to-lymphocyte ratio was significantly correlated with diabetic nephropathy progression and increased neutrophil-to-lymphocyte ratio can be considered as an early indicator and a prognostic risk marker of diabetic nephropathy.



Diabetic nephropathy, urinary albumin-to-creatinine ratio, neutrophil-to-lymphocyte ratio



Subramani et al. Bioinformation 19(4): 375-379 (2023)


Edited by

P Kangueane






Biomedical Informatics



This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.