Published 2023-05-08
Tanaya Ghinorawa Gilang samudera Indrawarman Soeroharjo Ahmad Zulfan Hendri Andy zulfiqqar


Objective: This study aims to evaluate the association of the preoperative Neutrophil-lymphocyte ratio (NLR) and postoperative creatinine levels after kidney transplantation, which is a predictor factor for determining early postoperative transplantation complications. Material & Methods: We conducted a retrospective study of 33 patients enrolled in Sardjito General Hospital in Yogyakarta between 2017 and 2020. In this study, we observed the preoperative NLR and compared it with the postoperative creatinine level. The data were compared and analyzed. Results: This study showed that preoperative NLR in these 33 patients was 4.17 + 2.82. Postoperative creatinine levels were 2.38 + 1.75 mg/dL. Postoperative creatinine levels were higher in patients with low preoperative NLR (p=0.00). Besides, the correlation is weak and had a positive correlation direction (r=0.379). Conclusion: This study showed preoperative NLR and the postoperative serum creatinine level is correlated even weakly. NLR could be considered a predictor factor for determining postoperative transplantation complications, and even it still needs further research.



Neutrophil-lymphocyte ratio, creatinine levels, kidney transplantation


Song M., Graubard B.I., Rabkin C.S., Engels E.A. Neutrophil-to-lymphocyte ratio and mortality in the United States general population. Sci. Rep. 2021; 11: 464.

17. Tamhane U.U., Aneja S., Montgomery D., Rogers E.K., Eagle K.A., Gurm H.S. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am. J. Cardiol. 2008; 102: 653–657.

Templeton A.J., McNamara M.G., Šeruga B., Vera-Badillo F.E., Aneja P., Ocaña A., Leibowitz-Amit R., Sonpavde G., Knox J.J., Tran B., et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: A systematic review and meta-analysis. J. Natl. Cancer Inst. 2014; 106: dju124.

Hogendorf P, Suska A, Skulimowski A, Rut J, Grochowska M, Wencel A, et al. Neutrophil-lymphocyte ratio and creatinine reduction ratio predict good early graft function among adult cadaveric donor renal transplant recipients. Single institution series. Pol Przegl Chir. 2018 Apr; 90(2): 28–33.

Baral D, Yang Y, Katwal G, Li S, Wang S, Fan X, et al. Recipient Pre-Operative Neutrophil Lymphocyte Ratio Better Predicts Delayed Graft Function than Platelet Lymphocyte Ratio in Donation after Brain Death Kidney Transplantation. Med J Pokhara Acad Heal Sci. 2019; 2(2): 209–16.

Ergin G, Değer SM, Köprü B, Derici Ü, Arinsoy T. High neutrophil-to-lymphocyte ratio predicts acute allograft rejection in kidney transplantation: A retrospective study. Turkish J Med Sci. 2019; 49(2): 525–30.

Garg AX. Helping more patients receive a living donor kidney transplant. Clin J Am Soc Nephrol. 2018; 13(12): 1918–23.

Hayashi H, Takamura H, Ohbatake Y, Nakanuma S, Tajima H, Fushida S, et al. Postoperative changes in neutrophil-to-lymphocyte ratio and platelet count: A simple prognostic predictor for adult-to-adult living donor liver transplantation. Asian J Surg. 2018 Jul; 41(4): 341–8.

Walker PA, Kunjuraman B, Bartolo DCC. Neutrophil-to-lymphocyte ratio predicts anastomotic dehiscence. ANZ J Surg. 2018 Jan; 7-8: E573-E577.

Giakoumidakis K, Fotos N, Patelarou A, Theologou S, Argiriou M, Chatziefstratiou A, et al. Perioperative neutrophil to lymphocyte ratio as a predictor of poor cardiac surgery patient outcomes. Pragmatic Obs Res. 2017; 8: 9–14.

Kahramanca S, Ozgehan G, Seker D, Gökce EI, Seker G, Tunç G, et al. Neutrophil-to-lymphocyte ratio as a predictor of acute appendicitis. Ulus travma ve acil cerrahi Derg = Turkish J trauma Emerg Surg TJTES. 2014 Jan; 20(1): 19–22.

Halazun KJ, Marangoni G, Hakeem A, Fraser SM, Farid SG, Ahmad N. Elevated preoperative recipient neutrophil-lymphocyte ratio is associated with delayed graft function following kidney transplantation. Transplant Proc. 2013 Nov; 45(9): 3254–7.

Decruyenaere A, Decruyenaere P, Peeters P, Vermassen F, Dhaene T, Couckuyt I. Prediction of delayed graft function after kidney transplantation: Comparison between logistic regression and machine learning methods Standards, technology, and modeling. BMC Med Inform Decis Mak. 2015; 15(1): 1–10.

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Department of Urology, Faculty of Medicine/Airlangga University