{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T03:20:51Z","timestamp":1794626451870,"version":"4.9.1"},"reference-count":75,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T00:00:00Z","timestamp":1737763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Diabetic nephropathy (DN) is a major complication of diabetes mellitus and a leading cause of end-stage renal disease. Inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and red cell distribution width (RDW) have been proposed as potential predictors of DN progression. This study systematically reviews and meta-analyzes the role of these markers in DN. Materials and Methods: A comprehensive literature search was conducted to identify studies evaluating NLR, PLR, SII, and RDW in type 2 diabetes patients with normoalbuminuria, microalbuminuria, and macroalbuminuria. Five databases were searched: PubMed, Scopus, Embase, Web of Science, and LILACS. The Newcastle Ottawa Scale was used to assess the risk of bias in selected articles. Results: Out of 1556 records that were identified through searches, 40 were selected for the review. Finally, 35 were included for meta-analyses, including 13,519 patients. Higher levels of NLR, PLR, SII, and RDW were observed in macro- and microalbuminuria compared to normoalbuminuria, with significantly elevated NLR in microalbuminuria. Meta-analyses showed that NLR and RDW were significantly associated with higher odds of DN (NLR: OR 1.84, p &lt; 0.001; RDW: OR 1.9, p = 0.023). However, PLR and SII were not significantly associated with DN. A longitudinal study confirmed SII as a significant predictor of DN progression (hazard ratio: 3.24, p = 0.023). Conclusions: This study highlights the potential of NLR and RDW as predictive markers for diabetic nephropathy.<\/jats:p>","DOI":"10.3390\/medicina61020216","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T06:39:51Z","timestamp":1737959991000},"page":"216","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Inflammatory Markers as Predictors of Diabetic Nephropathy in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4218-8622","authenticated-orcid":false,"given":"Daniel-Corneliu","family":"Leucu\u021ba","sequence":"first","affiliation":[{"name":"Department of Medical Informatics and Biostatistics, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline Aur\u00e9lia","family":"Fumeaux","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Biostatistics, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8800-4935","authenticated-orcid":false,"given":"Oana","family":"Alm\u0103\u0219an","sequence":"additional","affiliation":[{"name":"Department of Prosthetic Dentistry and Dental Materials, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5508-2598","authenticated-orcid":false,"given":"\u0218tefan Lucian","family":"Popa","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7435-271X","authenticated-orcid":false,"given":"Abdulrahman","family":"Ismaiel","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,25]]},"reference":[{"key":"ref_1","unstructured":"Chevalier, N. 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