The correlation of neutrophil-percentage-to-albumin ratio with chronic kidney disease risk among the United States diabetic population

The neutrophil-percentage-to-albumin ratio (NPAR) is a novel biomarker. However, the relationship between the NPAR and the development of chronic kidney disease (CKD) in the diabetic population is still unclear. The purpose of this study was to investigate the potential association between the NPAR and CKD in the diabetic population. This cross-sectional study included participants in the National Health and Nutrition Examination Survey from 2009 to 2018. Analyses were performed via weighted multifactor logistic regression, subgroup analyses and weighted restricted cubic spline curves. Age, sex, race, family poverty-to-income ratio, education, smoking history, alcohol consumption, hypertension, hyperuricemia, hyperlipidemia, cardiovascular disease, and anemia were included as covariates. In addition to CKD, the estimated glomerular filtration rate and urinary albumin/creatinine ratio were used as outcomes to fit the models. A total of 2436 participants were included in the study after some who provided insufficient information were excluded. Weighted logistic regression models revealed that the NPAR was positively correlated with the incidence of CKD after controlling for all other variables (odds ratio: 1.13, 95% confidence interval: 1.06-1.20, P < .05). When NPAR was transformed into a categorical variable on the basis of quartiles, only the Q4 was independently associated with CKD incidence (odds ratio: 2.23, 95% confidence interval: 1.33-3.71, P < .05). There was a nonlinear relationship between CKD and NPAR (P < .05). Subgroup analyses revealed strong interactions between NPAR and age, male and hypertension (P < .05). The NPAR was positively correlated with an increased risk of CKD in the diabetic population. These results suggest that the NPAR may have potential utility in personalized management.