The association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red blood cell distribution width, and physical function in elderly non-dialysis patients with chronic kidney disease.

BACKGROUND

The physical function of elderly patients with chronic kidney disease (CKD) is influenced by chronic inflammatory status. This study aimed to investigate the association between systemic inflammatory markers—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW)—and physical function in elderly non-dialysis patients with CKD.

METHODS

Data were collected from CKD patients aged ≥ 60 years. Physical function was evaluated using the Barthel Index (BI) of the activities of daily living (ADL) scale. Participants were stratified into two groups: BI ≥ 60 and BI < 60. Differences in NLR, PLR, and RDW levels between the two groups were compared. Subsequently, multivariable logistic regression analysis was performed to assess the association of these three indicators (as continuous or categorical variables) with physical function.

RESULTS

A total of 1005 eligible patients were included, comprising 880 patients in the BI ≥ 60 group and 125 patients in the BI < 60 group. NLR (3.71 ± 1.78 vs. 2.82 ± 1.58, P < 0.001), PLR (158.50 ± 66.98 vs. 138.84 ± 63.48, P = 0.001), and RDW (14.01 ± 1.47 vs. 13.38 ± 1.30, P < 0.001) were significantly higher in the BI < 60 group compared to the BI ≥ 60 group. Multivariable regression analysis demonstrated that elevated NLR (OR = 1.278, 95% CI: 1.138–1.435, P < 0.001) and PLR (OR = 1.004, 95% CI: 1.001–1.006, P = 0.014) were independently associated with physical function dependence in elderly non-dialysis CKD patients.

CONCLUSION

Higher levels of NLR, PLR, and RDW were observed in elderly non-dialysis CKD patients with poor physical function. Elevated NLR and PLR were independently associated with physical function dependence.