Platelet-to-lymphocyte ratio may serve as marker of mortality in patients with AKI
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Key takeaways:
- Lower and higher platelet-to-lymphocyte ratio groups showed higher in-hospital mortality rates.
- Poor prognosis of these groups correlates with higher severity of illness and inflammation.
The platelet-to-lymphocyte ratio has potential to be a marker of mortality for patients with AKI, according to data published in Kidney Medicine.
“[Platelet-to-lymphocyte ratio] PLR has been demonstrated to be a prognostic factor in some diseases, such as cancer and myocardial infarction. Several studies have also shown that PLR is associated with the occurrence of contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction,” You Hyun Jeon, MD, from Kyungpook National University Hospital in Daegu, South Korea, and colleagues wrote. “However, studies on the role of PLR in patients with severe AKI are limited, especially in critically ill patients.”
In a retrospective cohort study, researchers examined data for 1,044 patients who experienced continuous kidney replacement therapy (CKRT) at Kyungpook National University Hospital between 2017 and 2021. Researchers collected laboratory results at the time of CKRT, then calculated the PLR of patients using the ratio of platelets to lymphocytes.
Patients were categorized into quintiles based on their PLR values.
With PLR serving as the exposure, researchers considered in-hospital mortality the primary outcome of the study. Using Cox proportional hazards model, researchers explored the relationship between PLR and mortality.
Analyses revealed a non-linear correlation between PLR and in-hospital mortality, with a higher mortality rate in both the lower and higher PLR groups. The highest mortality rates were within the first and fifth quintiles, whereas the lowest mortality rate was in the third quintile. Similarly, the first and fifth quintiles maintained an increased risk of 30-day and 90-day mortality compared with the third quintile.
Researchers identified lower and higher PLRs as predictors of in-hospital mortality among patients with older ager, female sex, hypertension, diabetes and higher Sequential Organ Failure Assessment score.
“[T]his is the first study to our knowledge to provide a prognostic analysis according to PLR in patients with severe AKI who underwent CKRT in the ICU. We confirm a U-shaped relationship between PLR and mortality, underlining the need for special attention in these high-risk groups. Further studies are needed to validate the PLR index as a predictor of mortality and understand the mechanisms of the immune system involved,” Jeon and colleagues wrote. They added, “We found that both lower and higher PLR groups had significantly higher in-hospital mortality. In addition, poor prognosis of the lower and higher PLR groups was associated with the higher severity of acute illness and increased inflammation. These results suggest that PLR represents a complex medical condition and could be a readily available marker of mortality in patients with severe AKI.”
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