Prognostic Value of Neutrophil Lymphocyte Ratio for Early Renal Failure in ECMO Patients

Purpose We aimed to investigate the relationship between the early renal failure during Ecmo and Neutrophil Lymphocyte Ratio, which may be an indicator of a systemic inflammatory response. Methods We retrospectively evaluated the patients with Ecmo due to postcardiotomic shock after elective CABG surgery in our institution between 2012-2018. AKIN and KDIGO criteria were used to group patients into respective AKI Stages. Early renal failure was defined as renal failure within 72 hours of ECMO initiation. Results Of the 119 patients, 68.1% were female. The mean age of the patients was 54.62 ± 12.94, and the mean duration of ECMO was 6.69 ± 5.75 days, and 73.1% were canullated centrally. There was a statistically significant difference between postoperative NLR levels according to the presence of AKIN / KDİGO (p = 0.004; p <0.01), (Table 1). According to the presence of AKIN / KDİGO, cut off point for postop NLR was found to be 6.71 and above. ROC curve for postop NLR level according to AKIN / KDİGO is shown in Figure 1. In cases with postoperative NLR level 6.71 and above, the risk of AKIN / KDİGO is 5.941 times higher. The ODDS ratio for the Postop NLR measurement was 5.941 (95% CI: 2.133-16.546). Conclusion NLR increase was significant in the first three days of Ecmo in patients who developed renal failure. This increase can be due to an inflammatory response that plays a role in the pathogenesis of renal injury during Ecmo run and NLR can be an accessible and useful indicator for early diagnosis of the renal failure and inflammatory response. We aimed to investigate the relationship between the early renal failure during Ecmo and Neutrophil Lymphocyte Ratio, which may be an indicator of a systemic inflammatory response. We retrospectively evaluated the patients with Ecmo due to postcardiotomic shock after elective CABG surgery in our institution between 2012-2018. AKIN and KDIGO criteria were used to group patients into respective AKI Stages. Early renal failure was defined as renal failure within 72 hours of ECMO initiation. Of the 119 patients, 68.1% were female. The mean age of the patients was 54.62 ± 12.94, and the mean duration of ECMO was 6.69 ± 5.75 days, and 73.1% were canullated centrally. There was a statistically significant difference between postoperative NLR levels according to the presence of AKIN / KDİGO (p = 0.004; p <0.01), (Table 1). According to the presence of AKIN / KDİGO, cut off point for postop NLR was found to be 6.71 and above. ROC curve for postop NLR level according to AKIN / KDİGO is shown in Figure 1. In cases with postoperative NLR level 6.71 and above, the risk of AKIN / KDİGO is 5.941 times higher. The ODDS ratio for the Postop NLR measurement was 5.941 (95% CI: 2.133-16.546). NLR increase was significant in the first three days of Ecmo in patients who developed renal failure. This increase can be due to an inflammatory response that plays a role in the pathogenesis of renal injury during Ecmo run and NLR can be an accessible and useful indicator for early diagnosis of the renal failure and inflammatory response.