Neutrophil-to-Lymphocyte Ratio as a Predictor of Renal Function Decline Based on Serum Urea, Creatinine, and Estimated Glomerular Filtration Rate in Non-Hemodialysis Chronic Kidney Disease Patients

Abstract

Chronic kidney disease (CKD) is a progressive condition affecting 9–13% of the global population, with diabetes and hypertension being the predominant risk factors. Chronic low-grade inflammation contributes to CKD progression, and the neutrophil-to-lymphocyte ratio (NLR) provides a simple and routinely available inflammatory index. This study examined whether NLR was associated with serum urea, serum creatinine, and estimated glomerular filtration rate (eGFR) in non-hemodialysis CKD patients. A cross-sectional analytical study was conducted at Dr. H. Abdul Moeloek Regional Hospital, Bandar Lampung, from March to May 2026. Using consecutive sampling, 264 patients with CKD stages G2–G4 were enrolled. Spearman’s correlation analysis was applied with a significance threshold of p < 0.05. The mean NLR was 2.52 ± 1.32. NLR demonstrated a positive correlation with serum creatinine (rs = +0.151; p = 0.014) and a negative correlation with eGFR (rs = −0.155; p = 0.012), whereas no significant correlation was observed with serum urea (rs = +0.066; p = 0.284). The consistent direction of NLR associations with creatinine and eGFR supports its potential as a cost-effective supplementary marker for monitoring renal function decline in resource-limited settings.