Association of Neutrophil-to-Lymphocyte Ratio With Early Diabetic Nephropathy in Patients With Type 2 Diabetes Mellitus

Background: Type 2 diabetes mellitus (T2DM) is a chronic condition associated with a range of complications, one of the most significant being diabetic nephropathy (DN). It is a leading cause of kidney failure, and its early detection is crucial for delaying disease progression. While traditional markers are commonly used, they often detect renal impairment only in more advanced stages. Since chronic inflammation is a key contributor to the development of diabetic complications, the neutrophil-to-lymphocyte ratio (NLR) may serve as a useful and cost-effective biomarker of early DN in patients with T2DM. Objective: To determine whether elevated NLR levels are associated with early markers of renal dysfunction, and to assess the predictive value of NLR in identifying early-stage DN in type 2 diabetic patients. Methods: A total of 126 T2DM patients satisfying the inclusion criteria were included in the study after taking informed consent. Subjects were divided into two groups based on the presence (66) and absence (60) of albuminuria. Fasting blood sugar, glycated hemoglobin, NLR, blood urea, serum creatinine, urinary albumin excretion, urinary albumin creatinine ratio, and estimated glomerular filtration rate were noted to assess renal function. Results: A total of 126 patients diagnosed with type 2 diabetes were registered in our study. The mean NLR for patients without albuminuria was 1.96 ± 0.54, and for the DN group, it was 3.06 ± 0.98, which was significant (p < 0.001). Also, a strong positive correlation was seen between NLR and markers of early DN (r = 0.42, p = 0.001). Conclusion: A significant correlation was found between NLR and markers of early DN in patients with T2DM. NLR may be considered a cost‑effective surrogate biomarker for the early detection of DN, enabling timely intervention strategies to mitigate progression of nephropathy in T2DM.