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

Abstract

Introduction The aim of this 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 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. Conclusions 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. © 2025 Urology Research Center (URC), Tehran University of Medical Sciences.