Relationship between Serial Serum Neutrophil-Lymphocyte Ratio, Cardiovascular Mortality, and All-Cause Mortality in Chinese Peritoneal Dialysis Patients

Abstract Introduction: It is believed that the excessive cardiovascular (CV) burden of patients on peritoneal dialysis (PD) is closely associated with chronic inflammation. Neutrophil-lymphocyte ratio (NLR) is an inflammatory marker that was shown to correlate with CV outcomes. However, little is kn...

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Published in:Kidney & blood pressure research 2023-01, Vol.48 (1), p.414-423
Main Authors: Lau, Lik Fung Sam, Ng, Jack K.C., Fung, Winston W.S., Chan, Gordon C.K., Cheng, Phyllis Mei-Shan, Chow, Kai Ming, Leung, Chi Bon, Li, Philip Kam-To, Szeto, Cheuk Chun
Format: Article
Language:English
Subjects:
Biomarkers
Cardiovascular disease
Cardiovascular Diseases
China
Dialysis
Humans
Inflammation
Kidney diseases
Leukocytes (neutrophilic)
Lymphocyte Count
Lymphocytes
Monitoring
Mortality
Neutrophils
Peritoneal Dialysis
Peritoneum
Prognosis
Research Article
Retrospective Studies
Statistical analysis
Survival
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Summary:Abstract Introduction: It is believed that the excessive cardiovascular (CV) burden of patients on peritoneal dialysis (PD) is closely associated with chronic inflammation. Neutrophil-lymphocyte ratio (NLR) is an inflammatory marker that was shown to correlate with CV outcomes. However, little is known about the significance of serial monitoring of serum NLR. We aimed to determine the prognostic value of serial NLR on all-cause mortality and CV mortality in PD patients. Methods: Serial measurement of NLR was obtained from 225 incident PD patients in a single center, with each measurement 1 year apart. Patients were divided into two groups (“high” vs. “low”) by the median value of NLR. The primary and secondary outcome measure was all-cause and CV mortality, respectively. Results: After a median of follow-up for 43.9 months, patients with lower baseline NLR demonstrated a higher survival rate (p = 0.01). Patients with persistently high NLR values on serial measurement had the lowest survival rate (p = 0.03). Multivariate Cox regression showed that this group of patients had significantly higher all-cause mortality (HR: 1.74, 95% CI: 1.09–2.79, p = 0.02). However, the NLR failed to demonstrate a statistically significant relationship with CV mortality. Conclusions: While baseline NLR was an independent predictor of all-cause mortality in PD patients, persistent elevation in NLR appeared to further amplify the risk. Regular monitoring of serial serum NLR may enable early identification of patients who are at risk of adverse outcome.
ISSN:1420-4096
1423-0143
DOI:10.1159/000530554