medigraphic.com
ISSN 0326-3428 (Print)
Órgano de difusión científica de la Asociación Nefrológica de Buenos Aires

2024, Number 3

<< Back Next >>

Rev Nefrol Dial Traspl 2024; 44 (3)

The diagnostic utility of systemic immune inflammation index in differentiating crescentic glomerulonephritis subtypes

Sezer GE, Ozdemir A, Kansu AD, Yilmaz M

Language: English
References: 25
Page: 142-150
PDF size: 238.63 Kb.


ABSTRACT

Introduction: Hematological indices have been used as a marker for differential diagnosis or prognostic prediction of diverse diseases. Since no study has been conducted to search for the relationship between the systemic immune inflammation index (SII) and crescentic glomerulonephritis (GN), we aim to investigate the diagnostic utility of SII in crescentic GN subtypes. Methods: In this retrospective study, patients with crescentic GN were divided into three groups: type 1 crescentic GN (n=1), type 2 crescentic GN (n=44), and type 3 crescentic GN (n=44). There was only one patient in the type 1 crescentic GN group, so he was excluded. The groups were compared regarding SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). The SII was calculated by platelet count × neutrophil count/lymphocyte count. The predictive ability of these indices was determined by using the receiver operating characteristic (ROC) curve analysis. Also, the correlation of the indices with inflammatory markers and renal function tests was analyzed. Results: Patients with crescentic GN type 3 had higher levels of urea, creatinine, erythrocyte sedimentation rate (ESR), SII, NLR, and PLR levels; they showed lower levels of 24-hour protein excretion rate and estimated glomerular filtration rate (eGFR) compared to crescentic GN type 2 group. According to the ROC curve, SII had the highest level of discriminating crescentic GN subtypes, and NLR was the lowest. Also, there was a significant positive correlation between SII and the percentage of crescentic glomeruli, urea, and creatinine, as well as a negative correlation between SII and eGFR. Conclusions: This study revealed that a high SII might reflect the severity of kidney injury in patients with crescentic GN. Further studies with large series are needed to confirm the above results.


REFERENCES

  1. Greenhall GH, Salama AD. What is new in themanagement of rapidly progressive glomerulonephritis?Clin Kidney J. 2015; 8:143–50. https://doi.org/ 10.1093/ckj/sfv008.

  2. Lee T, Gasim A, Derebail VK, et al. Predictors oftreatment outcomes in ANCA-associated vasculitiswith severe kidney failure. Clin. J. Am. Soc. Nephrol.2014; 9: 905–913. https://doi: 10. 2215 /CJN.08290813

  3. Couser WG. Rapidly progressive glomerulonephritis:classification, pathogenetic mechanisms, andtherapy. Am J Kidney Dis. 1988; 11:449. https://doi.org/10.1016/S0272-6386(88)80079-9

  4. Jennette JC. Rapidly progressive crescenticglomerulonephritis. Kidney Int. 2003; 63: 1164.https://doi.org/10. 1046/j.1523-1755.2003.00843.x

  5. Hu B, Yang XR, Xu Y, et al. Systemic immuneinflammationindex predicts prognosis of patients aftercurative resection for hepatocellular carcinoma. ClinCancer Res. 2014; 20:6212–6222. https://doi.org/10.1158/1078-0432.CCR-14-0442

  6. Motomura T, Shirabe K, Mano Y, et al. Neutrophillymphocyteratio reflects hepatocellularcarcinoma recurrence after liver transplantationvia inflammatory microenvironment. J Hepatol. 2013;58:58-64. https://doi.org/10. 1016/j.jhep.2012.08.017

  7. Feng JF, Huang Y, Chen QX. Preoperative plateletlymphocyte ratio (PLR) is superior to neutrophillymphocyte ratio (NLR) as a predictive factor in patientswith esophageal squamous cell carcinoma. World JSurg Oncol. 2014; 12.https://doi.org/10.1186/1477-7819-12-58

  8. Hu ZD, Sun Y, Guo J, et al. Red blood cell distributionwidth and neutrophil/lymphocyte ratio are positivelycorrelated with disease activity in primary Sjogren’ssyndrome. Clin Biochem. 2014. https://doi.org/10.1016/j.clinbiochem.2014.08.022

  9. Sen BB, Rifaioglu EN, Ekiz O, et al. Neutrophilto lymphocyte ratio as a measure of systemicinflammation in psoriasis. Cutan Ocul Toxicol.2014; 33:223-227. https://doi.org/10.3109/15569527.2013.834498

  10. Ruonan Y, Qian C, Xianchun M, et al. Prognosticvalue of Systemic immune-inflammation index incancer: A meta-analysis. J Cancer. 2018; 9(18):3295-3302. https://doi.org/10. 7150/JCA.25691

  11. Jian-Hui C, Er-Tao Z, Yu-Jie Y, et al. Systemicimmune-inflammation index for predictingprognosis of colorectal cancer. World J Gastroenterol.2017 September 14; 23(34):6261-6272. https://doi.org/ 10. 3748/wjg.v23.i34.6261

  12. Ya LY, Cheng HW, Pai FH, et al. Systemic immuneinflammationindex (SII) predicted clinical outcome inpatients with coronary artery disease. Wiley Apr. 20209-11. https://doi.org/: 10.1111/eci.13230

  13. Kim Y, Choi H, Jung SM et al. Systemic immuneinflammationindex could estimate the crosssectionalhigh activity and the poor outcomesin immunosuppressive drug-naïve patients withantineutrophil cytoplasmic antibody-associatedvasculitis. Nephrology (Carlton). 2019. Epub2019 Apr 29. Jul;24(7):711-717. https://doi.org/:10.1111/nep.13491.

  14. 14) Tanacan E, Dincer D, Erdogan FG, et al. A cutoffvalue for the systemic immune‐inflammation indexin determining activity of Behçet disease. Clin ExpDermatol. 2021;46(2):286‐291. https://doi.org/:10.1111/ced.14432

  15. Inker LA, Eneanya ND, Coresh J, et al. ChronicKidney Disease Epidemiology Collaboration. NewCreatinine- and Cystatin C-Based Equations toEstimate GFR without Race. N Engl J Med. 2021;385:1737. https://doi.org/: 10.1056/NEJMoa2102953

  16. Jennette JC, Thomas DB, Falk RJ. Microscopicpolyangiitis (microscopic polyarteritis). Seminars inDiagnostic Pathology. 2001 Feb;18(1):3-13. PMID:11296991.

  17. 17) Imig JD, Ryan MJ. Immune and inflammatory rolein renal disease. Compr. Physiol. 2013 Apr;3(2):957-76. doi: 10.1002/cphy.c120028.

  18. Ahn SS, Jung SM, Song JJ, et al. Neutrophil tolymphocyte ratio at diagnosis can estimate vasculitisactivity and poor prognosis in patients with ANCAassociatedvasculitis: a retrospective study. BMCNephrol. 2018; 19: 187. https://doi.org/10.1186/s12882-018-0992-4

  19. Gasparyan AY, Ayvazyan L, Mukanova U,et al. The Platelet-to-Lymphocyte Ratio as aninflammatory marker in rheumatic diseases. AnnLab Med. 2019;39:345–357. https://doi.org/10.3343/alm.2019.39.4.345

  20. Park HJ, Jung SM, Song JJ, et al. Platelet tolymphocyte ratio is associated with the currentactivity of ANCA-associated vasculitis at diagnosis:a retrospective monocentric study. Rheumatol Int.2018;38: 1865–1871. https://doi.org/10. 1007/s00296-018-4125-y

  21. Baodong Q, Ning M, Qingqin T, et al (2015): Neutrophilto lymphocyte ratio (NLR), platelet to lymphocyteratio (PLR) were Useful Markers in Assessment ofInflammatory Response and Disease Activity in SLEpatients. Modern Rheumatology. https://doi.org/:10.3109/14397595.2015.1091136

  22. Chen JB, Tang R, Zhong Y, et al. Systemic immuneinflammationindex predicts a reduced risk of end-stagerenal disease in Chinese patients with myeloperoxidaseanti-neutrophil cytoplasmic antibody-associatedvasculitis: A retrospective observational study. ExpTher Med. 2021 Sep;22(3):989. doi: 10. 3892/etm.2021. 10421.

  23. Arzu O, Erdem B, Muhammed K, etal. Could systemic immune inflammation index bea new parameter for diagnosis and disease activityassessment in systemic lupus erythematosus?International Urology and Nephrology. https://doi.org/10. 1007/s11255-022-03320-3

  24. Qin Z, Li H, Wang L, Geng J, et al. Systemic Immune-Inflammation Index Is Associated With IncreasedUrinary Albumin Excretion: A Population-BasedStudy. Front Immunol. 2022 Mar 21;13:863640. doi:10.3389/fimmu.2022.863640.

  25. Baldwin DS, Neugarten J, Feiner HD, et al.The existence of a protracted course in crescenticglomerulonephritis. Kidney Int. 1987;31(3):790.https://doi.org/10. 1038/ki.1987.67




2020     |     www.medigraphic.com