Neutrophil-to-Lymphocyte Ratio as a Predictor of Polyomavirus BK Nephropathy in Kidney Transplant Patients.
1Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan
2Department of Surgery and Oncology, Kyushu University, Fukuoka, Japan.
Meeting: 2016 American Transplant Congress
Abstract number: D224
Keywords: Biopsy, Infection, Lymphocytes, Polyma virus
Session Information
Session Name: Poster Session D: Polyomavirus
Session Type: Poster Session
Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Neutrophil-to-lymphocyte ratio (NLR) is an index for systemic inflammatory response, and has been reported to be a prognostic marker in the patients with malignancies and cardiovascular diseases. On the other hand, organ transplant recipients receive immunosuppressive treatment, and corticosteroids and tacrolimus are known to increase NLR. Accordingly, we hypothesized that high NLR might also associate with over-immunosuppression and the risk of infectious complication in kidney transplant patients.
Methods: From July 2008 through May 2014, 492 adult patients received living or deceased donor kidney transplantation in Kyushu University Hospital. We compared the NLR at allograft biopsy in the patients with polyomavirus BK nephropathy (BKVN group, n=19), acute T-cell mediated rejection (≥Banff IA, TCMR group, n=84), and no evidence of rejection in both 3-month and 12-month protocol biopsies (control group, n=146). All patients did not have infectious diseases, surgical interventions, and anti-rejection treatments at least 1 month before allograft biopsy. We also investigated the serial changes in NLR after the modification of immunosuppression in BKVN group.
Results: NLR at allograft biopsy was significantly higher in BKVN group than those in TCMR and control groups (5.0±2.2, 3.2±1.4, and 2.9±1.4, respectively, p<0.001). Among all patients, the optimal NLR as a marker of BKVN diagnosis was 3.08 (area under the curve 0.816; sensitivity 89.5%, specificity 64.7%). In the BKVN group, NLR significantly decreased after the treatment (NLRs at diagnosis, after 1 month, 2 months, and 3 months were 5.0±0.4, 3.4±1.7, 3.0±1.5, and 3.3±1.2, respectively, p<0.001).
Conclusions: High NLR could be a marker of over-immunosuppression as well as systemic inflammation, and have a predictive value for BKVN in kidney transplant patients.
CITATION INFORMATION: Masutani K, Tsuchimoto A, Matsukuma Y, Kaku K, Kurihara K, Okabe Y, Tsuruya K, Nakamura M, Kitazono T. Neutrophil-to-Lymphocyte Ratio as a Predictor of Polyomavirus BK Nephropathy in Kidney Transplant Patients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Masutani K, Tsuchimoto A, Matsukuma Y, Kaku K, Kurihara K, Okabe Y, Tsuruya K, Nakamura M, Kitazono T. Neutrophil-to-Lymphocyte Ratio as a Predictor of Polyomavirus BK Nephropathy in Kidney Transplant Patients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/neutrophil-to-lymphocyte-ratio-as-a-predictor-of-polyomavirus-bk-nephropathy-in-kidney-transplant-patients/. Accessed May 11, 2025.« Back to 2016 American Transplant Congress