The prognostic value of elevated neutrophil-lymphocyte ratio for cardiac surgery-associated acute kidney injury: A systematic review and meta-analysis

Wheatley, J; Liu, Z; Loth, J; Plummer, MP; Penny-Dimri, JC; Segal, R; Smith, J; Perry, LA

Author(s): Wheatley, J; Liu, Z; Loth, J; Plummer, MP; Penny-Dimri, JC; Segal, R; Smith, J; Perry, LA;
Details: Publication Year 2023-02,Volume 67,Issue #2,Page 131-141
Journal Title: Acta Anaesthesiologica Scandinavica
Publication Type: Review
Abstract: BACKGROUND: Patients undergoing cardiac surgery are at significant risk of developing postoperative acute kidney injury (AKI). Neutrophil-lymphocyte ratio (NLR) is a widely available inflammatory biomarker which may be of prognostic value in this setting. METHODS: We conducted a systematic review and meta-analysis of studies reporting associations between perioperative NLR with postoperative AKI. We searched Medline, Embase and the Cochrane Library, without language restriction, from inception to May 2022 for relevant studies. We meta-analysed the reported odds ratios (ORs) with 95% confidence intervals (CIs) for both elevated preoperative and postoperative NLR with risk of postoperative AKI and need for renal replacement therapy (RRT). We conducted a meta-regression to explore inter-study statistical heterogeneity. RESULTS: Twelve studies involving 10,724 participants undergoing cardiac surgery were included, with eight studies being deemed at high risk of bias using PROBAST modelling. We found statistically significant associations between elevated preoperative NLR and postoperative AKI (OR 1.45, 95% CI 1.18-1.77), as well as postoperative need for RRT (OR 2.37, 95% CI 1.50-3.72). Postoperative NLR measurements were not of prognostic significance. CONCLUSIONS: Elevated preoperative NLR is a reliable inflammatory biomarker for predicting AKI following cardiac surgery.
Publisher: Wiley
Keywords: Humans; Prognosis; Neutrophils; Lymphocytes; *Cardiac Surgical Procedures/adverse effects; Biomarkers; *Acute Kidney Injury/diagnosis/etiology; Acute Kidney Injury; Biomarker; Cardiac Surgery; Neutrophil-lymphocyte ratio
Department(s): Surgical Oncology
PubMed ID: 36367845
Publisher's Version: https://doi.org/10.1111/aas.14170
Open Access at Publisher's Site: https://doi.org/10.1111/aas.14170
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-06-15 07:24:56

Last Modified: 2023-06-15 07:25:48