Relationship Between Neutrophil Percentage to Albumin Ratio and Kidney Disease: Systematic Review and Meta-Analysis Publisher



Saberi K ; Mokhtariardekani A ; Sharifi S ; Safari M ; Marahemi M ; Khosravi N ; Roohinezhad R ; Rastad H ; Razmi M
Source: Journal of Renal Injury Prevention Published:2026

Abstract

Introduction: The neutrophil percentage-to-albumin ratio (NPAR) has emerged as a valuable biomarker for the detection and assessment of inflammatory conditions. Given the prominent role of inflammation in the pathophysiology of kidney disorders, the present study aimed to examine the association between NPAR and the risk of developing kidney disease. Materials and Methods: This study was conducted as a systematic review and meta-analysis, designed in accordance with the PRISMA guidelines. In line with this framework, the Cochrane, Scopus, Web of Science, Embase, and PubMed databases, as well as the Google Scholar search engine, were systematically searched up to December 19, 2025. All statistical analyses were performed using STATA version 14. Results: Elevated NPAR was significantly associated with an increased risk of kidney disease in the overall population (OR = 1.62, 95% CI: 1.37–1.91), as well as among men (OR = 1.31, 95% CI: 1.15–1.50), women (OR = 1.30, 95% CI: 1.14–1.48), and individuals younger than 60 years (OR = 1.71, 95% CI: 1.42–2.06). Participants in the highest NPAR quartile demonstrated a markedly greater risk of kidney disease compared with those in the first quartile (OR = 2.04, 95% CI: 1.46–2.84), the third quartile (OR = 1.40, 95% CI: 1.13–1.72), and the second quartile (OR = 1.19, 95% CI: 1.07–1.31). Similarly, individuals in the third NPAR tertile exhibited a substantially higher risk relative to the first tertile (OR = 4.40, 95% CI: 2.26–8.58) and the second tertile (OR = 2.63, 95% CI: 1.34–5.19). Furthermore, elevated NPAR was identified as a significant risk factor for both chronic kidney disease (CKD) (OR = 1.46, 95% CI: 1.17–1.82) and diabetic kidney disease (OR = 1.86, 95% CI: 1.43–2.43). Conclusion: Elevated NPAR was associated with a higher likelihood of developing kidney disease, and this risk increased progressively with rising NPAR levels. Men demonstrated a slightly greater vulnerability compared with women, and a younger age (<60 years) further amplified this association. Additionally, individuals with higher NPAR values exhibited a greater propensity for developing diabetic kidney disease than CKD. Copyright © 2026 The Author(s);