Abstract

Chronic inflammation can have a considerable impact on the progression of glomerular and tubulointerstitial pathologies in chronic kidney disease (CKD). As an alternative to the early detection of inflammatory markers that are most important in the progression of CKD, this study aims to analyze the association of MLR, NLR, and TNF-? with the stages of CKD. This cross-sectional study conducted at Universitas Airlangga Hospital, Surabaya, Indonesia, in mid-2023 involved 65 CKD subjects, consisting of 5 stages of CKD according to KDIGO guidelines. eGFR was calculated using the CKD-EPI creatinine equation. MLR and NLR were calculated from the differential count hematology analyzer Sysmex XN-550. TNF-α was examined using the sandwich ELISA method. Random-spot urine was used for the UACR examination (TMS 24i Premium Chemical Analyzer). There were significant differences in MLR and TNF-α at various stages of CKD (p0.05). There was a significant association between MLR (p0.05). In conclusion, MLR is better for assessing the progression of chronic kidney disease compared to NLR and TNF-α.

Key words: Chronic kidney disease, Inflammation, Monocyte to lymphocyte ratio, Neutrophil to lymphocyte ratio, Tumor necrosis factor alpha, Urine Albumin-to-Creatinine Ratio.