Neutrophil-to-Lymphocyte Ratio and Renal Function in Hypertensive Crisis Patients

Background: The incidence of hypertensive crisis patients worldwide has been estimated at 1-2% of the population. The objective of this study was to evaluate the correlation between neutrophil-to-lymphocyte ratio and renal function in the acute state of hypertensive crisis.
Methods: The study was conducted in Citra Husada hospital in Jember, East Java, Indonesia, including 167 consecutive patients admitted to the hospital between January and December 2019 to diagnose hypertensive crisis. The neutrophil-to-lymphocyte ratio was counted as neutrophil count (/µL) divided by lymphocyte count (/µL). The estimated glomerular filtration rate (ml/min/1.73 m2) was calculated with the Modification of Diet in Renal Disease equation.
Results: Hypertensive crisis proportion was lower in male (40.7%, 68 patients) than females (59.3%, 99 patients). The hypertensive emergency incidence was higher (92.2%, 154 patients) with cerebral events as the most frequent target organ damage (64.1%, 107 patients). neutrophilto-lymphocyte ratio was significantly lower in hypertensive emergency patients (p=0.033), while estimated glomerular filtration rate was significantly higher in hypertensive emergency patients (p=0.046). neutrophil-to-lymphocyte ratio and estimated glomerular filtration rate correlation was significant (p=0.036) with a very weak score (r=-0.163) and coefficient of determination
0.266. A decrease of estimated glomerular filtration rate of 26.6 % will follow each increase in neutrophil-to-lymphocyte ratio.
Conclusion: This study suggested a relationship between the increasing neutrophil-to-lymphocyte ratio with decreasing estimated glomerular filtration rate in hypertensive crisis patients.
Further studies are needed to evaluate whether the increase in neutrophil-to-lymphocyte ratio was an acute or chronic disease process.