The Relationship Between Neutrophil Percentage/Albumin Ratio and Risk Stratification and Prognosis in Patients with Idiopathic Membranous Nephropathy

XU Li; ZHU Huaxia; GUO Kaiqi; HUANG Lanlan; LI Xiaowei

doi:10.3639/j.issn.2095-3097.2025.07.017

Abstract：Objective To explore the relationship between neutrophil percentage/albumin ratio(NPAR)and risk stratification and prognosis in patients with idiopathic membranous nephropathy(IMN).Methods A total of 244 IMN pa-tients admitted to Fuyang People's Hospital from February 2017 to December 2022 were selected.According to the risk strati-fication of IMN patients,they were divided into low-risk group(n=50),medium-risk group(n=165)and high-risk group(n=29).Spearman correlation analysis was used to analyze the relationship between NPAR and IMN risk stratification.The study par-ticipants was further divided into a good prognosis group(n=179)and a poor prognosis group(n=65)based on prognosis.The predictive value of NPAR for IMN prognosis was analyzed using the receiver operating characteristic(ROC)curve.The influ-encing factors of IMN prognosis were explored by multivariate logistic stepwise regression.Results The NPAR of the medi-um-risk group and high-risk group was higher than that of the low-risk group,and the albumin(ALB)was lower than that of the low-risk group(P<0.05).The NPAR of the high-risk group was higher than that of the medium-risk group,and the ALB was lower than that of the medium-risk group(P<0.05).NPAR was positively correlated with the risk stratification of IMN pa-tients(r=0.608,P<0.001),and ALB was negatively correlated with the risk stratification of IMN patients(r=-0.514,P<0.001).The NPAR of the poor prognosis group was significantly higher than that of the good prognosis group,and the ALB was signifi-cantly lower than that of the good prognosis group(P<0.05).ROC curve analysis showed that the AUC of NPAR for predicting the prognosis of IMN patients was 0.906,which was significantly higher than that of ALB at 0.726(Z=12.533,P<0.001).The proportion of high-risk IMN,hypertension,diabetes,glomerular sclerosis,and serum creatinine levels in the poor prognosis group was significantly higher than those in the good prognosis group(P<0.05).Multivariate analysis showed that high-risk IMN,diabetes,glomerular sclerosis,and NPAR≥2.50 were independent risk factors for the prognosis of IMN patients(P<0.05).Conclusion NPAR is closely related to IMN risk stratification,and high NPAR is an independent risk factor for IMN prog-nosis,which has certain clinical value in predicting IMN prognosis.