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All Journal Indonesian Journal of Global Health research Indonesian Journal of Global Health Research
Nindia Sugih Arto
Universitas Sumatera Utara
Education Health Professions Languange, Linguistic, Communication & Media Nursing Public Health

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Neutrophil-To-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Predictors of Mortality in Chronic Kidney Disease Patients Undergoing Hemodialysis Roy Efendi Silaban; Nindia Sugih Arto; Mohammad Riza Lubis
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6998

Abstract

Chronic Kidney Disease (CKD) is associated with high mortality, especially among patients undergoing hemodialysis (HD). Inflammation markers such as the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) have been linked to mortality prediction. This study aims to evaluate the role of NLR and PLR as mortality predictors in CKD patients undergoing HD at H. Adam Malik Hospital, Medan. This retrospective study analyzed CKD patients receiving HD from January to December 2023, aged 18-60 years, and undergoing routine HD for at least 3 months. Excluded were those with comorbidities, immunosuppressant use, or incomplete records. Data on demographics, laboratory values (including NLR and PLR), and mortality outcomes were collected. ROC curve and logistic regression analysis were used. Out of 108 patients, 35 (32.4%) died. The median NLR was significantly higher in the mortality group (7.89 vs. 3.41, p < 0.001), while PLR showed no significant difference. ROC analysis revealed NLR's moderate accuracy (AUC = 73.3%, cut-off = 5). Multivariate analysis identified coronary artery disease history, age, and creatinine levels as significant mortality factors. NLR is a moderate predictor of mortality in CKD patients undergoing HD, while PLR is not.
Relationship Between Serum Uric Acid, Serum Uric Acid-to-Creatinine Ratio and Estimated Glomerular Filtration Rate in Patients with Stage 3–5 Chronic Kidney Diseases Shella Shella; Nindia Sugih Arto; Radar Radius Tarigan; Malayana Rahmita Nasution; Mohammad Riza Lubis; Sylvia Youvella
Indonesian Journal of Global Health Research Vol. 8 No. 5 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i5.2140

Abstract

Chronic kidney disease (CKD) is a global health problem with high disease progression. Hyperuricemia is frequently observed in CKD; however, its diagnostic value is limited in advanced stages due to decreased renal excretion. Therefore, the serum uric acid–to–creatinine ratio (SUA/SCr) has the potential to serve as a more representative parameter, as it reflects uric acid metabolism adjusted for kidney function. This study aimed to evaluate the correlation between serum uric acid levels, the SUA/SCr ratio, and the estimated glomerular filtration rate (eGFR) in patients with stage 3, 4, and 5 chronic kidney disease (CKD). This was an analytic study with a cross-sectional design with consecutive sampling involving 50 patients with stage 3, 4, and 5 chronic kidney disease (CKD) at Adam Malik Hospital. Serum uric acid and creatinine levels were measured using enzymatic methods, while the estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation. Correlation analysis was performed using Pearson or Spearman tests, and comparisons among CKD stages were conducted using one-way ANOVA or the Kruskal–Wallis test. A p-value of <0.05 was considered statistically significant. Serum uric acid levels showed no significant correlation with CKD stage (r=0.025; p=0.861) or eGFR (r=0.093; p=0.523). In contrast, the SUA/SCr ratio demonstrated a strong negative correlation with CKD stage (r=–0.784; p<0.001) and a strong positive correlation with eGFR (r=0.784; p<0.001). The SUA/SCr ratio also decreased significantly with increasing CKD stage. The serum uric acid-to-creatinine (SUA/SCr) ratio demonstrates a stronger correlation with renal function compared to serum uric acid levels in patients with non-hemodialysis chronic kidney disease (CKD) stages 3, 4, and 5. This parameter may serve as a potentially more sensitive alternative biomarker for assessing declining renal function.
Co-Authors Malayana Rahmita Nasution Mohammad Riza Lubis Radar Radius Tarigan Roy Efendi Silaban Shella Shella Sylvia Youvella