Copyright: Clinics Cardive Publishing (Pty) Ltd. publisher
of Cardiovascular Journal of Africa.
Abstract
Purpose:
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) surgery is a major complication. We investigated the association between platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR), which are associated with inflammation, with the development of AKI according to the Kidney Disease Improving Global Outcomes (KDIGO) 2012 criteria.
Methods: We retrospectively evaluated 96 patients who underwent CABG surgery between October 11, 2022 and July 31, 2024. Patients were divided into two groups: postoperative acute kidney injury (AKI) (n = 32) and non-AKI (n = 64). The diagnosis of AKI was based on changes in serum creatinine level according to KDIGO 2012 criteria.
Results: In patients who had developed acute kidney injury, several inflammatory markers were significantly increased. Preoperative PLR and NLR values were significantly higher in the AKI group when presented as median (interquartile range) (PLR: 145.8 [98.5 – 183.1] vs 118.4 [89.7 – 147.1], p = 0.018; and NLR: 3.8 [2.5 – 5.1] vs 2.9 [2.0 - 3.8], p = 0.009). The CRP/albumin ratio was significantly higher in the AKI group (0.21 [0.14 – 0.32] vs 0.14 [0.09 – 0.22], p = 0.008). ROC analysis showed moderate discriminative ability for both markers, with AUC values of 0.728 (95% CI: 0.627 - 0.829) for PLR and 0.692 (95% CI: 0.588 -0.796) for NLR. Multivariate analysis identified preoperative PLR > 132.5 as an independent predictor of AKI (OR: 2.41, 95% CI: 1.02 - 5.68, p = 0.044).
Conclusion: Our findings suggest that elevated PLR and NLR values are associated with increased risk of AKI after CABG surgery. The preoperative PLR ratio with a cut-off value of 132.5 and other inflammatory ratios can be used as independent predictors of post-CABG AKI. We suggest that these easily accessible markers may provide valuable information regarding the risk of AKI development following CABG
Methods: We retrospectively evaluated 96 patients who underwent CABG surgery between October 11, 2022 and July 31, 2024. Patients were divided into two groups: postoperative acute kidney injury (AKI) (n = 32) and non-AKI (n = 64). The diagnosis of AKI was based on changes in serum creatinine level according to KDIGO 2012 criteria.
Results: In patients who had developed acute kidney injury, several inflammatory markers were significantly increased. Preoperative PLR and NLR values were significantly higher in the AKI group when presented as median (interquartile range) (PLR: 145.8 [98.5 – 183.1] vs 118.4 [89.7 – 147.1], p = 0.018; and NLR: 3.8 [2.5 – 5.1] vs 2.9 [2.0 - 3.8], p = 0.009). The CRP/albumin ratio was significantly higher in the AKI group (0.21 [0.14 – 0.32] vs 0.14 [0.09 – 0.22], p = 0.008). ROC analysis showed moderate discriminative ability for both markers, with AUC values of 0.728 (95% CI: 0.627 - 0.829) for PLR and 0.692 (95% CI: 0.588 -0.796) for NLR. Multivariate analysis identified preoperative PLR > 132.5 as an independent predictor of AKI (OR: 2.41, 95% CI: 1.02 - 5.68, p = 0.044).
Conclusion: Our findings suggest that elevated PLR and NLR values are associated with increased risk of AKI after CABG surgery. The preoperative PLR ratio with a cut-off value of 132.5 and other inflammatory ratios can be used as independent predictors of post-CABG AKI. We suggest that these easily accessible markers may provide valuable information regarding the risk of AKI development following CABG
Submitted: June 12, 2025;
Accepted: July 31, 2025;
Published: October 17, 2025
Cardiovasc J Afr 2025; 36: 558-567
Volume 36, Issue 4
Cardiovasc J Afr 2025; 36: 558-567
Volume 36, Issue 4
DOI Citation Reference: dx.doi.org/10.5830/CVJA-2025-079