The clinical significance of the naples prognostic score in adult idiopathic nephrotic syndrome: a retrospective study.

BACKGROUND: Nephrotic syndrome (NS) is characterized by heavy proteinuria, hypoalbuminemia, and edema due to glomerular filtration barrier damage. While NS is classified as steroid-sensitive (SSNS) or steroid-resistant (SRNS), the role of inflammatory and nutritional biomarkers in predicting disease severity remains understudied. Naples Prognostic Score (NPS), combining serum albumin, cholesterol, neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR), has prognostic value in inflammatory diseases, but its role in NS is unclear. OBJECTIVE: This study evaluated NPS in adult idiopathic nephrotic syndrome (AINS) to assess its relationship with disease severity, progression, and inflammatory/nutritional status. METHODS: A retrospective analysis included 248 adult NS patients from 2015-2025. After excluding 54 with secondary causes, 194 patients with idiopathic NS were analyzed. Demographic, biochemical, hematologic, proteinuria, and kidney function data were collected. NPS was calculated and stratified into two groups: 1-2 and 3-4. Spearman's correlation examined associations with clinical parameters. RESULTS: Patients with NPS 3-4 had higher creatinine and neutrophil counts (p < 0.001) and lower lymphocyte counts (p < 0.001) than those with NPS 1-2. NPS negatively correlated with lymphocytes (ρ = - 0.544) and cholesterol (ρ = - 0.392), and positively with neutrophils (ρ = 0.341) and creatinine (ρ = 0.263), all p < 0.001. These results indicate that NPS reflects inflammatory status and associates with kidney function. CONCLUSION: NPS is a promising biomarker for assessing inflammation, nutritional status, and disease severity in AINS. Prospective, multi-center studies are needed to validate its clinical utility and potential role in guiding individualized NS treatment.