Tropical Journal of Pathology and
Microbiology
2021 Volume 7 Number 1 January-February
E-ISSN:2456-1487
P-ISSN:2456-9887
RNI:MPENG/2017/70771
Research Article
Hormone
Publisher
www.medresearch.in
Relationship of Neutrophil Lymphocyte Ratio (NLR) with Parathyroid
Hormone (PTH) in Maintenance Hemodialysis Patients
Hazra A.
1*
, Mandal S.
2
, Chakraborty J.
3
DOI: https://doi.org/10.17511/jopm.2021.i01.03
1*
Asmita Hazra, Assistant Professor, Department of Biochemistry, Government Medical College, Pali, Rajasthan, India.
2
Saptarshi Mandal, Associate Professor, Department of Transfusion Medicine & Blood Bank, All India Institute of Medical Sciences, Jodhpur,
Rajasthan, India.
3
Jayati Chakraborty, Professor & Head, Department of Pathology, ESI-PGIMSR, Manicktala, Kolkata, India.
Background: Neutrophil-Lymphocyte-Ratio (NLR), a simple derived parameter of routine Complete
Blood Counts (CBC), has been shown to be better than WBC count as a marker for inflammation in
many contexts. Inflammation is associated with adverse outcomes in hemodialysis patients.
Methods: A cross sectional study was designed on 100 maintenance hemodialysis Patients in a
tertiary care hospital in Eastern India after IRB permission and informed consent. 88 complete
results became available. Complete blood count (CBC), routine PTH and biochemistry analysis were
performed. KDIGO 2009 cut offs were used to classify patients by PTH levels (PTH<2ULN, PTH 2-
9ULN & PTH>9 ULN). NLR was calculated and NLR of 3.5 was used as high inflammation cut off.
Results: In Analysis of 88 samples, significant Pearson Correlation with NLR was shown by Albumin,
Hemoglobin, PTH, Gender, Age, and Sugar, but involved collinearities. Multiple Linear Regression
with Robust estimation of Standard Errors retained only PTH as a significant predictor (Beta=
-0.273, P=0.033) of NLR and Albumin as a borderline significant predictor (Beta= -0.501, P=
0.061). The population was partitioned into 3 sets based on PTH as per KDIGO guideline.
Conclusion: Our study suggests that PTH is a significant predictor of inflammation as measured by
NLR, independent of the other parameters, and it has an overall weak negative association with
inflammation especially in the mid-range (PTH 2-9 ULN) subgroup, which largely corroborates with
available but scant literature.
Keywords: Hemodialysis (HD), Neutrophil Lymphocyte Ratio (NLR), Parathyroid Hormone (PTH),
Inflammation, Multiple Regression
Corresponding Author How to Cite this Article To Browse
Asmita Hazra, Assistant Professor, Department of
Biochemistry, Government Medical College, Pali,
Rajasthan, India.
Email:
Hazra A, Mandal S, Chakraborty J. Relationship of
Neutrophil Lymphocyte Ratio (NLR) with Parathyroid
Hormone (PTH) in Maintenance Hemodialysis
Patients. Trop J Pathol Microbiol. 2021;7(1):17-25.
Available From
https://pathology.medresearch.in/index.php/jopm/ar
ticle/view/510
Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2020-12-01 2020-12-10 2020-12-15 2021-12-24
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
No Nil Yes 6%
© 2021 by Asmita Hazra, Saptarshi Mandal, Jayati Chakraborty and Published by Siddharth Health Research and Social Welfare
Society. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License
https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].
Tropical Journal of Pathology and Microbiology 2021 ;7 (1 ) 17