ASSOCIATION OF NEUTROPHIL-TO-LYMPHOCYTE RATIO WITH REDUCED eGFR IN PATIENTS WITH HYPERTENSION AT TIGARAKSA REGIONAL GENERAL HOSPITAL

Abstract

Hypertension is an important risk factor for impaired kidney function, and systemic inflammation may contribute to renal injury. The neutrophil-to-lymphocyte ratio (NLR) is an accessible inflammatory marker derived from routine hematological testing. This study evaluated the association between NLR and reduced estimated glomerular filtration rate (eGFR) among patients with hypertension. An analytical cross-sectional study was conducted using secondary data from medical records at Tigaraksa Regional General Hospital. Patients with hypertension aged ≥30 years who had complete demographic and laboratory data were included using total sampling. NLR was calculated from neutrophil and lymphocyte values, while eGFR was estimated using the CKD-EPI equation. Reduced eGFR was defined as <60 mL/min/1.73 m². The primary exposure was categorized as NLR ≥3.0 versus <3.0. Associations were evaluated using chi-square and multivariable binary logistic regression. Receiver operating characteristic (ROC) analysis was performed to assess the discriminatory performance of continuous NLR. Ninety participants were analyzed. Reduced eGFR occurred in 53.5% of participants with NLR ≥3.0 and 36.2% of those with NLR <3.0. In the final adjusted model, NLR ≥3.0 was associated with higher odds of reduced eGFR (adjusted odds ratio [aOR] 2.48, 95% confidence interval [CI] 0.96–6.43; p=0.061). Continuous NLR showed limited discrimination (area under the curve 0.606, 95% CI 0.488–0.725; p=0.077). The NLR ≥3.0 category showed a positive but statistically non-significant association with reduced eGFR. NLR may have potential as an adjunctive marker of inflammatory burden, but its clinical utility for identifying reduced eGFR requires further evaluation.