Albumin-to-Globulin and Neutrophil-to-Lymphocyte Ratios: Potential Prognostic Markers for Delayed Graft Function in Kidney Transplantation

Introduction: One of the frequent issues in deceased donor kidney transplantation is called Delayed graft function (DGF). There wasn’t a study reporting the prognostic predictive value of preoperative albumin to globulin ratio (AGR) and neutrophil to lymphocyte ratio (NLR) in DGF patients undergoing kidney transplantation. Hence, the primary objective of this prospective study is to evaluate the relation among preoperative AGR and NLR with a prognosis of DGF in patients who underwent renal transplantation.Methods: The outcome data were extracted including DGF occurrence, readmission, postoperative complications, and length of stay (LOS) at the hospital. We performed univariable and step-wise multivariable analysis to evaluate their impact on DGF and other mentioned outcomes. Collecting the recipients’ laboratory data before renal transplantation was performed.Results: The average (±SD) age of the 124 patients at renal transplantation was 42.85 (±14.39) years. AGR and NLR are not significantly related with the occurrence of DGF. TIBC (OR=0.981, P-value=0.038) was an independent negative prognostic factor for DGF occurrence. Age (RR=1.01, P-value<0.001), NLR (RR=1.186, P-value<0.001), Iron (RR=1.003, P-value=0.002) were independent positive risk factors for LOS, while increasing AGR (RR=0.713, P-value<0.001) and WBC (RR=0.954, P-value<0.001) were independent negative prognostic factors. WBC (OR=1.525, P-value=0.016) was an independent positive prognostic factor for readmission. Age (OR=1.12, P-value=0.009) and iron (OR=1.074, P-value=0.004) were independent positive prognostic factors for complication occurrence, and AGR (OR=0.0486, P-value=0.045) was a negative independent prognostic factor.Conclusion: AGR and NLR are not considerably related with the occurrence of DGF and readmission. NLR was a positive prognostic factor for LOS and AGR was a negative prognostic factor for occurrence of complications and increasing LOS.