Which one is the predictor of carotid intima media thickness in patients with aglomerulonephritis; neutrophil-to-lymphocyte ratio or proteinuria?

Purpose:Glomerulonephritis is inflammation of the glomeruli and proteinuria itself is a reflection of the glomerular inflammation. In this study we aimed to investigate the relationship between carotid intima media thickness (CIMT) one of the earliest findings of atherosclerosis and markers of glomerular inflammation. Materials and methods:40 patients with biopsy proven glomerulonephritis and 46 healthy controls were enrolled in the study.Human Growth arrest spesific protein 6 (Gas6) levels in serum samples were studied by ELISA.CIMT measurement was performed by the same radiologist. Results: The mean age was 42,88±15,41in patient group and 38,26±9,04 in controls. The mean duration of illness was 29.07±52.90 mounts, proteinuria was4027.05±4030.22 mg/day, MDRD-GFR was 53.80±48.32 mL/min/1.73m2. CIMT was 0.62±0.17 mm in patient group,0.46±0.10 mm in controls.Neutrophil-to-Lymphocyte Ratio (NLR) was 3.69±4.46 in patient group and significantly higher than control group (1.74±0.63). Gas6 levels were statistically higher in control group. CIMT was positively correlated with age, fibrinogen, ferritin, proteinuria and NLR and negatively correlated with HDL cholesterol and Gas6 in glomerulonephritis group. Age was the predictor for CIMT in the logistic regression model. In all group CIMT was positively correlated with age, creatinine, uric acid, fibrinogen, ferritin, CaxP product, proteinuria and NLR and negatively correlated with hemoglobin level, Gas6. In lineer logistic regression analysis carotid IMT was significantly associated with age and ferritin and proteinuria. Conclusion: We have shown that proteinuria is one of the main determinants of increased CIMT independent from the GFR levels in glomerulonephritis with relatively preserved renal function