JMIR Publications

ABSTRACT

Background:

A growing body of research has implicated systemic inflammation in the pathogenesis of diabetic nephropathy (DN), with several studies focusing on the neutrophil-to-lymphocyte ratio (NLR) as a potential biomarker.

Objective:

This systematic review aims to evaluate the predictive and prognostic role of NLR in DN and its potential to aid in clinical decision-making and management strategies.

Methods:

The protocol was designed in accordance with the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive literature search in the MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and Scopus databases will be executed without language restrictions to identify eligible studies. We will conduct data analysis, synthesis and generate forest plots using RStudio version 4.5.1. Continuous outcomes will be presented as standardized mean difference (SMD) with 95% confidence interval (CI) and dichotomous outcomes will be reported as odds ratio (OR) with 95% CI. When two or more studies with similar designs, interventions and outcomes provide sufficient data, we will perform meta-analysis.

Results:

The search identified 1,122 records after deduplication. Following title and abstract screening, 123 full texts are eligible for screening to be included in the final review. Data extraction and analysis are planned for manuscript completion by March 2026.

Conclusions:

This study will provide a comprehensive synthesis of the current evidence on the association between NLR and the onset of DN, as well as its potential role as a prognostic marker and its clinical utility. Prospero registration: CRD42025641025.