[Elevated neutrophil-lymphocyte ratio and delayed graft function].

Background: Delayed graft function (DGF) is a significant complication in kidney transplantation, adversely affecting graft and recipient survival. Therefore, it is important to establish tools that help predict this condition. The elevation of the neutrophil-to-lymphocyte ratio (NLR) has been studied as a predictor of DGF, with the premise that its increase is associated with systemic inflammation and, consequently, DGF.

Objective: To analyze the association between an elevated NLR in the preoperative period and delayed graft function in kidney transplant recipients.

Materials and methods: A prospective, observational, analytical, and longitudinal study. The sample included all patients admitted to the Nephrology Transplant Service at Hospital de Especialidades No. 1, Centro Médico Nacional Bajío, in 2023.

Results: We found that an NLR greater than 3.5 in the preoperative period of patients undergoing kidney transplantation had 80% specificity and 28% sensitivity, compared to patients with an NLR of 3.5 or lower.

Conclusions: There is no association between an elevated NLR in the preoperative period and delayed kidney graft function after transplantation. However, it may be associated with other risk factors, as demonstrated in the multivariate analysis, which revealed that donor acute kidney injury increased the likelihood of developing DGF by almost 200%.