# Elevated neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in peripheral blood are associated with higher risk of atherosclerotic renal artery stenosis

## TL;DR

High levels of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in blood are linked to a higher risk and severity of atherosclerotic renal artery stenosis (ARAS), suggesting they could be useful diagnostic indicators.

## Contribution

This study identifies NLR and PLR as novel potential biomarkers for diagnosing and assessing severity of atherosclerotic renal artery stenosis.

## Key findings

- NLR and PLR levels are elevated in patients with atherosclerotic renal artery stenosis (ARAS) and increase with stenosis severity.
- PLR independently predicts ARAS risk, while NLR shows a nonlinear threshold effect at 3.56.
- Combining NLR and PLR with age and serum creatinine improves diagnostic accuracy for ARAS.

## Abstract

The prevalence of atherosclerotic renal artery stenosis (ARAS) has been steadily increasing, yet reliable non-invasive diagnostic methods are lacking. This study investigated the association of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) with atherosclerotic renal artery stenosis (ARAS).

Data were collected from a total of 1,026 patients, including 362 with ARAS and 664 without. RCS, Logistic regression analysis and stratified analysis were conducted to identify significant risk factors. The diagnostic value of PLR and NLR in predicting the occurrence and severity of ARAS was evaluated using receiver operating characteristic curve analysis.

NLR and PLR were elevated in ARAS patients and increased with stenosis severity (NLR r = 0.83). NLR exhibited a nonlinear threshold effect at 3.56, with stronger associations below this cutoff. PLR independently predicted ARAS risk (OR 1.009, p < 0.001). ROC analysis showed moderate diagnostic performance, which improved when NLR and PLR were combined with age and serum creatinine (AUC 0.711). In subgroup analyzes, NLR association was amplified in renal impairment, while PLR interaction was significant only in the overweight/obese group.

Elevated levels of NLR and PLR are associated with an increased risk of developing ARAS. Moreover, a higher NLR is linked to more severe stenosis in ARAS cases. Therefore, NLR and PLR have the potential to serve as novel indicators for diagnosing ARAS.