Implementing novel complete blood count-derived inflammatory indices in the diabetic kidney diseases diagnostic models.

Objectives: Hemogram inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red-cell distribution width (RDW), and mean platelet volume (MPV) have been associated with type 2 diabetes mellitus (T2DM) and its complications, namely diabetic kidney diseases (DKD). We aimed to develop and validate logistic regression (LR) and CatBoost diagnostic models and study the role of adding these markers to the models.

Methods: All individuals who were managed in our secondary care center from March 2020 to December 2023 were identified. After excluding the ineligible patients, train-test splitting, and data preprocessing, two baseline LR and CatBoost-based models were developed using demographic, clinical, and laboratory features. The AUC-ROC of the models with biomarkers (NLR, PLR, RDW, and MPV) was compared to the baseline models. We calculated net reclassification improvement (NRI) and integrated discrimination index (IDI).

Results: One thousand and eleven T2DM patients were eligible. The AUC-ROC of both LR (0.738) and CatBoost (0.715) models was comparable. Adding target inflammatory markers did not significantly change the AUC-ROC in both LR and CatBoost models. Adding RDW to the baseline LR model reclassified 41.7% of patients without DKD, in the cost of misclassification of 38.4% of DKD cases. This change was absent in CatBoost models, and other markers did not achieve improved NRI or IDI.

Conclusion: The basic models with demographical and clinical features had acceptable performance. Adding RDW to the basic LR model improved the reclassification of the non-DKD participants. However, adding other hematological indices did not significantly improve the LR and CatBoost models' performance.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-024-01523-2.