Observational studyBMC cardiovascular disorders2025
Association of neutrophil-to-lymphocyte ratio with the risk of kidney failure in critically ill patients with heart failure: a cohort study.
Observational study in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe neutrophil-to-lymphocyte ratio (NLR) reflects systemic inflammation. Whether higher NLR is associated with subsequent kidney failure among critically ill patients with heart failure (HF) remains uncertain.
methodsUsing MIMIC-IV v3.1, we identified 3,368 ICU patients with HF. Baseline NLR was analyzed as tertiles and as a continuous variable (raw NLR and ln[NLR]). Cause-specific Cox proportional hazards models were used to estimate associations with 1-year kidney failure (with deaths as a competing event), 1-year all-cause mortality, and kidney failure over the entire follow-up.
resultsOver 1 year, 293/3,368 (8.7%) developed kidney failure. Higher NLR was associated with greater kidney-failure risk. Compared with the lowest tertile, the highest tertile had a higher hazard of 1-year kidney failure (HR 1.61, 95% CI 1.20-2.15). As a continuous exposure, ln(NLR) was associated with kidney failure at 1 year (HR 1.26, 95% CI 1.10-1.43) and over the entire follow-up (HR 1.22, 95% CI 1.09-1.37). For mortality, ln(NLR) was associated with higher 1-year all-cause mortality (HR 1.32, 95% CI 1.23-1.41) and the highest tertile showed greater risk versus the lowest (HR 1.79, 95% CI 1.52-2.10).
conclusionAmong ICU patients with HF, higher baseline NLR was associated with greater hazards of kidney failure and all-cause mortality. More studies are required to confirm these findings.
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