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已发表论文
系统性炎症生物标志物（中性粒细胞与淋巴细胞比值、单核细胞与淋巴细胞比值、血小板与淋巴细胞比值、系统性炎症指数、系统性免疫炎症指数）与子痫前期相关肾损伤的关联：一项回顾性观察研究
Authors Gao LN, Yan D, Liu XH, Chen D, Guo H, Liu J
Received 6 June 2025
Accepted for publication 8 September 2025
Published 15 September 2025 Volume 2025:18 Pages 12725—12738
DOI https://doi.org/10.2147/JIR.S542136
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Wenjian Li
Li-na Gao,1,2 Dong Yan,2 Xiao-hui Liu,2 De Chen,1,3 Hong Guo,3 Jian Liu1,3
1The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, People’s Republic of China; 2The Second Obstetrics Department, Gansu Provincial Maternity and Child Health Hospital (Gansu Provincial General Hospital), Lanzhou, Gansu, People’s Republic of China; 3Department of Intensive Care Unit, Gansu Provincial Maternity and Child Health Hospital (Gansu Provincial General Hospital), Lanzhou, Gansu, People’s Republic of China
Correspondence: Jian Liu, Email medecinliujian@163.com
Background: Approximately 7– 13% of pregnant women with preeclampsia (PE) develop acute kidney injury (AKI), which is one of the most serious complications of PE and is linked to long-term chronic kidney disease. This retrospective observational study investigated the association between inflammation indices and PE-related acute kidney injury (PE-AKI).
Methods: This retrospective study analyzed 4071 PE patients admitted between 2013 and 2023. Inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), were derived from complete blood counts. Multivariate logistic regression assessed associations with PE-AKI risk, with nonlinear relationships characterized using restricted cubic spline models.
Results: Among 4071 patients with PE, 290 (7.13%) developed AKI. Multivariate analysis (Model 3) revealed significant positive associations between log2-transformed inflammatory indices and PE-AKI risk, with the highest odds ratios observed for MLR (OR = 6.02, 95% CI: 4.68– 7.73; P < 0.0001) and NLR (OR = 3.93, 95% CI: 3.09– 5.01; P < 0.0001). MLR demonstrated the strongest independent correlation with PE-AKI (highest tertile OR = 7.24, 95% CI: 4.75– 11.02), followed by SIRI (OR = 5.78, 95% CI: 3.89– 8.59). All indices (NLR, MLR, PLR, SII, SIRI) exhibited linear dose-response relationships with PE-AKI risk (P-overall < 0.001 for each). Subgroup analyses further identified elevated MLR as a prominent risk factor in early-onset PE (gestational age ≤ 32 weeks; OR = 8.81, 95% CI: 4.91– 17.10) and patients with complications (OR = 7.28, 95% CI: 5.23– 10.32).
Conclusion: MLR and SIRI are positively associated with PE-AKI risk, particularly in early-onset and complicated cases. This first comprehensive assessment of five biomarkers supports clinical utility. Prospective validation is required, with focus on monocyte-mediated inflammatory mechanisms.
Keywords: preeclampsia, acute kidney injury, inflammation index, biomarkers
1The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, People’s Republic of China; 2The Second Obstetrics Department, Gansu Provincial Maternity and Child Health Hospital (Gansu Provincial General Hospital), Lanzhou, Gansu, People’s Republic of China; 3Department of Intensive Care Unit, Gansu Provincial Maternity and Child Health Hospital (Gansu Provincial General Hospital), Lanzhou, Gansu, People’s Republic of China
Correspondence: Jian Liu, Email medecinliujian@163.com
Background: Approximately 7– 13% of pregnant women with preeclampsia (PE) develop acute kidney injury (AKI), which is one of the most serious complications of PE and is linked to long-term chronic kidney disease. This retrospective observational study investigated the association between inflammation indices and PE-related acute kidney injury (PE-AKI).
Methods: This retrospective study analyzed 4071 PE patients admitted between 2013 and 2023. Inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), were derived from complete blood counts. Multivariate logistic regression assessed associations with PE-AKI risk, with nonlinear relationships characterized using restricted cubic spline models.
Results: Among 4071 patients with PE, 290 (7.13%) developed AKI. Multivariate analysis (Model 3) revealed significant positive associations between log2-transformed inflammatory indices and PE-AKI risk, with the highest odds ratios observed for MLR (OR = 6.02, 95% CI: 4.68– 7.73; P < 0.0001) and NLR (OR = 3.93, 95% CI: 3.09– 5.01; P < 0.0001). MLR demonstrated the strongest independent correlation with PE-AKI (highest tertile OR = 7.24, 95% CI: 4.75– 11.02), followed by SIRI (OR = 5.78, 95% CI: 3.89– 8.59). All indices (NLR, MLR, PLR, SII, SIRI) exhibited linear dose-response relationships with PE-AKI risk (P-overall < 0.001 for each). Subgroup analyses further identified elevated MLR as a prominent risk factor in early-onset PE (gestational age ≤ 32 weeks; OR = 8.81, 95% CI: 4.91– 17.10) and patients with complications (OR = 7.28, 95% CI: 5.23– 10.32).
Conclusion: MLR and SIRI are positively associated with PE-AKI risk, particularly in early-onset and complicated cases. This first comprehensive assessment of five biomarkers supports clinical utility. Prospective validation is required, with focus on monocyte-mediated inflammatory mechanisms.
Keywords: preeclampsia, acute kidney injury, inflammation index, biomarkers