DOI: https://doi.org/10.14710/dmj.v12i5.37592

Correlation of the Neutrophil-to-Lymphocytes Ratio with Serum Urea and Creatinine Levels in Leptospirosis Patients

*Dwi Retnoningrum orcid  -  Department of Clinical Pathology, Universitas Diponegoro Semarang, Indonesia
Teddy Dharmawan  -  Department of Clinical Pathology, Universitas Diponegoro Semarang

Citation Format:
Abstract
Background: Leptospirosis is a zoonosis that is still a problem in Indonesia. The kidneys are often the target organs in leptospirosis. The outer membrane of Leptospira Sp contains antigenic components and toxins that stimulate the inflammatory process in the kidneys. The neutrophil-to-lymphocyte ratio (NLR) is used as a marker of the inflammatory process, while urea creatinine is a sign of kidney damage. Objective: To prove the correlation between NLR and serum urea and creatinine levels in leptospirosis patients. Methods: This study was carried out retrospectively on the medical records of patients with confirmed leptospirosis by Microscopic Agglutination Test (MAT) at Dr. Kariadi Semarang between January 2020 and July 2022. NLR examination was obtained by dividing the number of neutrophils by the number of lymphocytes in the leukocyte count, urea, and creatinine levels from the patient's medical record. Statistical analysis using the Spearman correlation test, with a significance level of p <0.05. Results: From 33 samples, the median NLR was 10.75 (2.19-47,5), the median urea level was 131.0 mg/dL (15–467 mg/dL) creatinine 2.0 mg/dL (0.7-11.9 mg/dL). The correlation between NLR with urea (p=0.001 and r=0.561) and creatinine (p=0.003 and r=0.501). Increased NLR, urea, and creatinine were found in leptospirosis patients. Conclusion: There is a moderate positive correlation between NLR and urea and creatinine. An increase in NLR is a sign of an inflammatory process from leptospirosis. An increase in NLR correlates with an increase in urea and creatinine
Fulltext View|Download
Keywords: Neutrophil-to-lymphocyte ratio, Urea, Creatinine, Leptospirosis

Article Metrics:

Article Info
Section: Original Articles
Language : EN
Recent articles
Study Of Selection Of Delivery Assistance By Tbas In Materials In Masadian Village, Menui Sub-District, Menui Islands, Morowali District Correlation of the Neutrophil-to-Lymphocytes Ratio with Serum Urea and Creatinine Levels in Leptospirosis Patients Level Of Patient Satisfaction With Pharmaceutical Services In The Outpatient Pharmaceutical Room, Mandiraja Community Health Center 1 Avascular Necrosis Morbus Hansen Case Report: Hyperglycemia in Pregnancy and The Impacts on Fetal Welfare More recent articles
  1. Levett PN. Clinical Microbiology Reviews. American Society of Microbiology. 2001;14(2):296–326
  2. Wulandari E. Leptospirosis Prevention and Control in Indonesia [Internet]. World Health Organization. 2020 [cited 2022 Jun 20]. p.s. 1. Available from: https://www.who.int/indonesia/news/detail/24-08-2020-leptospirosis-prevention-and-control-in-indonesia
  3. Infection | Leptospirosis | CDC [Internet]. [cited 2022 June 20]. Available from: https://www.cdc.gov/leptospirosis/infection/index.html
  4. Pertiwi SMB, Setiani O, Nurjazuli. Environmental Factors Associated with Leptospirosis Incidence in Pati District, Central Java. J Indonesian Environmental Health. 2014;13(2):51–7
  5. RI Ministry of Health. Instructions for Leptospirosis Control Techniques. RI Ministry of Health [Internet]. 2017;126. Available from: http://infinemerging.kemkes.go.id/download/Buku_Petunjuk_Teknis_Pengendalian_Leptospirosis.pdf
  6. Central Java Health Service. Occupational Health Pocket Book of 2021 Quarter 1. Pocket Consult. 2021;3511351(24):172–6
  7. Brito T De. Pathology and pathogenesis of human leptospirosis. Rev Inst Med Trop Sao Paulo. 2018;60(April):e23err-e23err
  8. Samrot A V., Sean TC, Bhavya KS, Sahithya CS, Chandrasekaran S, Palanisamy R, et al. Leptospiral infection, pathogenesis, and its diagnosis—a review. Pathogens. 2021;10(2):1–30
  9. Yang CW, Pan MJ, Wu MS, Chen YM, Tsen YT, Lin CL, Wu CH, Huang CC. Leptospirosis: an ignored cause of acute renal failure in Taiwan. Am J Kidney Dis. 1997 Dec;30(6):840-5
  10. Santecchia I, Ferrer MF, Vieira ML, Gomez RM, Werts C. Phagocyte Escape of Leptospira: The Role of TLRs and NLRs. Front Immunol. 2020;11(October):1–2
  11. De Silva NL, Niloofa M, Fernando N, Karunanayake L, Rodrigo C, De Silva HJ, et al. Changes in full blood count parameters in leptospirosis: A prospective study. Int Arch Med. 2014;7(1):1–4
  12. Sukma FA, Mulida M, Sujana KS. Severe Leptospirosis. Cermin World Kedokt. 2021;48(11):353–6
  13. Zahorec R. Neutrophil-to-lymphocyte ratio, present, and future perspectives. Bratislavske lekarske listy, 2021;122(7), 474–488
  14. Nisansala T, Bandara K, Weerasekera M, Gunasekara C, Marasinghe C, Gamage C, et al. Manifestations and outcomes of leptospirosis during local outbreaks in high endemic districts of Sri Lanka: A retrospective multi-center study. Asian Pac J Trop Med. 2019;12(10):442–9. 15. Chirathaworn C, Inwattana R, Poovorawan Y, Suwancharoen D. Interpretation of microscopic agglutination test for leptospirosis diagnosis and seroprevalence. Asian Pacific Journal of Tropical Biomedicine. 2014;4
  15. Niloofa R, Fernando N, de Silva NL, Karunanayake L, Wickramasinghe H, Dikmadugoda N, et al. Diagnosis of leptospirosis: Comparison between microscopic agglutination test, IGM-ELISA and IGM rapid immunochromatography test. PLOS ONE. 2015;10(6)
  16. Haake DA, Levett PN. Leptospirosis in humans. Current Topics in Microbiology and Immunology. 2014;:65–97
  17. Cagliero J, Villanueva SY, Matsui M. Leptospirosis pathophysiology: Into the storm of cytokines. Frontiers in Cellular and Infection Microbiology. 2018;8
  18. Schulze MH, Raschel H, Langen HJ, Stich A, Tappe D. Severeleptospira interrogansserovar icterohaemorrhagiae infection with hepato‐renal‐pulmonary involvement treated with corticosteroids. Clinical Case Reports. 2014;2(5):191–6
  19. Santecchia I, Ferrer MF, Vieira ML, Gómez RM, Werts C. Phagocyte escape of Leptospira: The role of tlrs and nlrs. Frontiers in Immunology. 2020;11
  20. Edelstein CL. Biomarkers of acute kidney injury. Advances in Chronic Kidney Disease. 2008;15(3):222–34
  21. Budihal SV. Leptospirosis diagnosis: Competancy of various laboratory tests. Journal Of Clinical And Diagnostic Research. 2014; 199-202

Last update:

No citation recorded.

Last update:

No citation recorded.