Gulinuer Maimaititusvn, Nilupaer Jvnaiti, Maierhaba Kulaixi, Fang Liu
{"title":"儿童类固醇敏感性肾病综合征早期中性粒细胞与淋巴细胞比值及c反应蛋白的预测价值。","authors":"Gulinuer Maimaititusvn, Nilupaer Jvnaiti, Maierhaba Kulaixi, Fang Liu","doi":"10.3389/fneph.2025.1524231","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the predictive value of early neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels for relapse and adverse prognosis within one year in children diagnosed with steroid-sensitive nephrotic syndrome (SSNS).</p><p><strong>Methods: </strong>This study included a total of 145 pediatric patients diagnosed with steroid-sensitive nephrotic syndrome (SSNS) between January 2016 and December 2021. We collected early neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels, along with relevant clinical data, and conducted a one-year follow-up of the patients. Based on the follow-up outcomes, the patients were categorized into two groups: those who experienced a relapse and those who did not. We assessed the diagnostic and predictive value of NLR and CRP for relapse within one year using receiver operating characteristic (ROC) curve analysis and the Cox proportional hazards regression model.</p><p><strong>Results: </strong>After an average follow-up period of one year, 95 patients (65.52%) experienced relapse, while 50 patients (34.48%) did not. Significant differences were noted between the relapse and non-relapse groups regarding neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), 24-hour urinary protein levels, age at onset, and parental education level (P < 0.05). Cox proportional hazards regression analysis identified age at onset, NLR, CRP, and 24-hour urinary protein levels as significant risk factors for relapse in patients with steroid-sensitive nephrotic syndrome (SSNS). Receiver operating characteristic (ROC) curve analysis for the combined prediction of relapse using NLR, CRP, and 24-hour urinary protein levels demonstrated good predictive value, with an area under the curve (AUC) of 0.858 (95% CI: 0.80-0.916, P < 0.001). Kaplan-Meier survival analysis indicated that patients with elevated NLR (≥ 2.90) and CRP (≥ 25.30) exhibited the highest relapse rates and shorter survival times. Further Cox proportional hazards analysis revealed that children in the high NLR and high CRP groups were at an increased risk of relapse, rehospitalization, infection, prolonged cumulative steroid use, renal insufficiency, secondary hypertension, and other adverse outcomes within one year.</p><p><strong>Conclusion: </strong>Early levels of Neutrophil-to-Lymphocyte Ratio (NLR) and C-Reactive Protein (CRP) demonstrate significant predictive value for relapse and adverse prognosis within one year in children with Steroid-Sensitive Nephrotic Syndrome (SSNS). These markers can serve as effective tools for auxiliary clinical assessment.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1524231"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897826/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predictive value of early neutrophil-to-lymphocyte ratio and C-reactive protein in pediatric steroid-sensitive nephrotic syndrome.\",\"authors\":\"Gulinuer Maimaititusvn, Nilupaer Jvnaiti, Maierhaba Kulaixi, Fang Liu\",\"doi\":\"10.3389/fneph.2025.1524231\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aims to investigate the predictive value of early neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels for relapse and adverse prognosis within one year in children diagnosed with steroid-sensitive nephrotic syndrome (SSNS).</p><p><strong>Methods: </strong>This study included a total of 145 pediatric patients diagnosed with steroid-sensitive nephrotic syndrome (SSNS) between January 2016 and December 2021. We collected early neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels, along with relevant clinical data, and conducted a one-year follow-up of the patients. Based on the follow-up outcomes, the patients were categorized into two groups: those who experienced a relapse and those who did not. We assessed the diagnostic and predictive value of NLR and CRP for relapse within one year using receiver operating characteristic (ROC) curve analysis and the Cox proportional hazards regression model.</p><p><strong>Results: </strong>After an average follow-up period of one year, 95 patients (65.52%) experienced relapse, while 50 patients (34.48%) did not. Significant differences were noted between the relapse and non-relapse groups regarding neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), 24-hour urinary protein levels, age at onset, and parental education level (P < 0.05). Cox proportional hazards regression analysis identified age at onset, NLR, CRP, and 24-hour urinary protein levels as significant risk factors for relapse in patients with steroid-sensitive nephrotic syndrome (SSNS). Receiver operating characteristic (ROC) curve analysis for the combined prediction of relapse using NLR, CRP, and 24-hour urinary protein levels demonstrated good predictive value, with an area under the curve (AUC) of 0.858 (95% CI: 0.80-0.916, P < 0.001). Kaplan-Meier survival analysis indicated that patients with elevated NLR (≥ 2.90) and CRP (≥ 25.30) exhibited the highest relapse rates and shorter survival times. Further Cox proportional hazards analysis revealed that children in the high NLR and high CRP groups were at an increased risk of relapse, rehospitalization, infection, prolonged cumulative steroid use, renal insufficiency, secondary hypertension, and other adverse outcomes within one year.</p><p><strong>Conclusion: </strong>Early levels of Neutrophil-to-Lymphocyte Ratio (NLR) and C-Reactive Protein (CRP) demonstrate significant predictive value for relapse and adverse prognosis within one year in children with Steroid-Sensitive Nephrotic Syndrome (SSNS). These markers can serve as effective tools for auxiliary clinical assessment.</p>\",\"PeriodicalId\":73091,\"journal\":{\"name\":\"Frontiers in nephrology\",\"volume\":\"5 \",\"pages\":\"1524231\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-02-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897826/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in nephrology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/fneph.2025.1524231\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in nephrology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fneph.2025.1524231","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:本研究旨在探讨早期中性粒细胞与淋巴细胞比值(NLR)和c反应蛋白(CRP)水平对诊断为类固醇敏感性肾病综合征(SSNS)的儿童一年内复发和不良预后的预测价值。方法:本研究纳入了2016年1月至2021年12月期间诊断为类固醇敏感性肾病综合征(SSNS)的145例儿科患者。我们收集了早期中性粒细胞与淋巴细胞比值(NLR)和c反应蛋白(CRP)水平,以及相关临床数据,并对患者进行了一年的随访。根据随访结果,患者被分为两组:复发组和未复发组。我们使用受试者工作特征(ROC)曲线分析和Cox比例风险回归模型评估NLR和CRP对一年内复发的诊断和预测价值。结果:平均随访1年后,95例(65.52%)复发,50例(34.48%)未复发。复发组与非复发组在中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、c反应蛋白(CRP)、24小时尿蛋白水平、发病年龄、父母文化程度等方面差异均有统计学意义(P < 0.05)。Cox比例风险回归分析发现,发病年龄、NLR、CRP和24小时尿蛋白水平是激素敏感性肾病综合征(SSNS)患者复发的重要危险因素。NLR、CRP和24小时尿蛋白水平联合预测复发的受试者工作特征(ROC)曲线分析具有良好的预测价值,曲线下面积(AUC)为0.858 (95% CI: 0.80-0.916, P < 0.001)。Kaplan-Meier生存分析显示NLR(≥2.90)和CRP(≥25.30)升高的患者复发率最高,生存时间较短。进一步的Cox比例风险分析显示,高NLR和高CRP组的儿童在一年内复发、再住院、感染、长期累积使用类固醇、肾功能不全、继发性高血压和其他不良结局的风险增加。结论:早期中性粒细胞与淋巴细胞比值(NLR)和c反应蛋白(CRP)水平对类固醇敏感性肾病综合征(SSNS)患儿一年内复发和不良预后具有重要预测价值。这些指标可作为辅助临床评估的有效工具。
Predictive value of early neutrophil-to-lymphocyte ratio and C-reactive protein in pediatric steroid-sensitive nephrotic syndrome.
Objective: This study aims to investigate the predictive value of early neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels for relapse and adverse prognosis within one year in children diagnosed with steroid-sensitive nephrotic syndrome (SSNS).
Methods: This study included a total of 145 pediatric patients diagnosed with steroid-sensitive nephrotic syndrome (SSNS) between January 2016 and December 2021. We collected early neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels, along with relevant clinical data, and conducted a one-year follow-up of the patients. Based on the follow-up outcomes, the patients were categorized into two groups: those who experienced a relapse and those who did not. We assessed the diagnostic and predictive value of NLR and CRP for relapse within one year using receiver operating characteristic (ROC) curve analysis and the Cox proportional hazards regression model.
Results: After an average follow-up period of one year, 95 patients (65.52%) experienced relapse, while 50 patients (34.48%) did not. Significant differences were noted between the relapse and non-relapse groups regarding neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), 24-hour urinary protein levels, age at onset, and parental education level (P < 0.05). Cox proportional hazards regression analysis identified age at onset, NLR, CRP, and 24-hour urinary protein levels as significant risk factors for relapse in patients with steroid-sensitive nephrotic syndrome (SSNS). Receiver operating characteristic (ROC) curve analysis for the combined prediction of relapse using NLR, CRP, and 24-hour urinary protein levels demonstrated good predictive value, with an area under the curve (AUC) of 0.858 (95% CI: 0.80-0.916, P < 0.001). Kaplan-Meier survival analysis indicated that patients with elevated NLR (≥ 2.90) and CRP (≥ 25.30) exhibited the highest relapse rates and shorter survival times. Further Cox proportional hazards analysis revealed that children in the high NLR and high CRP groups were at an increased risk of relapse, rehospitalization, infection, prolonged cumulative steroid use, renal insufficiency, secondary hypertension, and other adverse outcomes within one year.
Conclusion: Early levels of Neutrophil-to-Lymphocyte Ratio (NLR) and C-Reactive Protein (CRP) demonstrate significant predictive value for relapse and adverse prognosis within one year in children with Steroid-Sensitive Nephrotic Syndrome (SSNS). These markers can serve as effective tools for auxiliary clinical assessment.