Neutrophil to lymphocyte ratio in predicting short-term mortality in hemodialysis patients

Year 2013, , 129 - 132, 31.07.2013

Emre Erdem , Coşkun Kaya Ahmet Karataş , Melda Dilek , Tekin Akpolat

https://doi.org/10.5835/jecm.omu.30.02.008

Abstract

Patients with end stage renal disease have a higher risk of mortality compared with the general population. The aim of the present study was to determine the value of neutrophil to lymphocyte ratio (NLR) in predicting mortality in hemodialysis patients. Fifty nine patients undergoing hemodialysis in our institution between January 2011 to June 2012 were analyzed. Baseline NLR, patient demographic, clinical, and biochemical parameters were obtained. The baseline median NLR value was 3.48. Patients were divided into two groups: Those with a NLR less than 3.48, and those greater than 3.48. The high NLR group had overall lower serum albumin levels (p=0.009) and higher C reactive protein levels (p=0.03). Seven (11.9%) patients died, and all were in the high NLR group (p=0.01). Hemodialysis patients with high NLR levels have increased risk of short term mortality.

Keywords

C reactive protein, Hemodialysis, Mortality, Neutrophil to lymphocyte ratio, Serum albumin

References

• Aliustaoglu, M., Bilici, A., Seker, M., Dane, F., Gocun, M., Konya, V., Ustaalioglu, B.B., Gumus, M., 2010. The association of pre-treatment peripheral blood markers with survival in patients with pancreatic cancer. Hepatogastroenterology. 57, 640-645.
• An., X., Mao, H.P., Wei, X, Chen, J.H., Yang, X., Li, Z.B., Yu, X.Q., Li, Z.J., 2012. Elevated neutrophil to lymphocyte ratio predicts overall and cardiovascular mortality in maintenance peritoneal dialysis patients. Int. Urol. Nephrol. 44, 1521-1528.
• Azab, B., Bhatt, V.R., Phookan, J., Murukutla, S., Kohn, N., Terjanian, T., Widmann, W.D., 2012. Usefulness of the neutrophil-to-lymphocyte ratio in predicting short- and long-term mortality in breast cancer patients. Ann. Surg. Oncol. 19, 217-224.
• Azab, B., Jaglall, N., Atallah, J.P., Lamet, A., Raja-Surya, V., Farah, B., Lesser, M., Widmann, W.D., 2011. Neutrophil-lymphocyte ratio as a predictor of adverse outcomes of acute pancreatitis. Pancreatology. 11, 445-452.
• Azab, B., Daoud, J., Naeem, F.B., Nasr, R., Ross, J., Ghimire, P., Siddiqui, A., Azzi, N., Rihana, N., Abdallah, M., Azzi, N., Patel, P., Kleiner, M., El-Sayegh, S., 2012. Neutrophil-to-lymphocyte ratio as a predictor of worsening renal function in diabetic patients (3-year follow-up study). Ren Fail. 34, 571-576.
• Bhutta, H., Agha, R., Wong, J., Tang, T.Y., Wilson, Y.G., Walsh, S.R., 2011. Neutrophil-lymphocyte ratio predicts medium-term survival following elective major vascular surgery: A cross-sectional study. Vasc. Endovascular. Surg. 45, 227-231.
• Cheung, A.K., Sarnak, M.J., Yan, G., Dwyer, J.T., Heyka, R.J., Rocco, M.V., Teehan, B.P., Levey, A.S., 2000. Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients. Kidney. Int. 58, 353-362.
• Daugirdas, J.T., 1993. Second generation logarithmic estimates of single pool variable volume Kt/V: An analysis of error. J. Am. Soc. Nephrol. 4, 1205-1213.
• Foley, R.N., Parfrey, P.S., Sarnak, M.J., 1998. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am. J. Kidney. Dis. 32, 112Honda, H., Ueda, M., Kojima, S., Mashiba, S., Suzuki, H., Hosaka, N., Hirai, Y., Nakamura, M., Nagai, H., Kato, N., Mukai, M., Watanabe, M., Takahashi, K., Shishido, K., Akizawa, T., 2012. Oxidized high-density lipoprotein as a risk factor for cardiovascular events in prevalent hemodialysis patients. Atherosclerosis. 220, 493-501.
• Johnson, D.W., Wiggins, K.J., Armstrong, K.A., Campbell, S.B., Isbel, N.M., Hawley, C.M., 2005. Elevated white cell count at commencement of peritoneal dialysis predicts overall and cardiac mortality. Kidney Int. 67, 738-743
• Jung, M.R., Park, Y.K., Jeong, O., Seon, J.W., Ryu, S.Y., Kim, D.Y., Kim, Y.J., 2011. Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer. J. Surg. Oncol. 104, 504-510.
• Kalantar-Zadeh, K., Brennan, M.L., Hazen, S.L., 2006. Serum myeloperoxidase and mortality in maintenance hemodialysis patients. Am. J. Kidney. Dis. 48, 59-68.
• Kamisli, S., Kamisli,O., Gonullu, S., Kaplan, Y., Ozcan, C., 2012. The prognostic value of increased leukocyte and neutrophil counts in the early phase of cerebral venous sinus thrombosis. Türk. Beyin. Damar. Hast. Derg. 18, 39-42.
• Kocyigit, I., Eroglu, E., Unal, A., Sipahioglu, M.H., Tokgoz, B., Oymak, O., Utas, C., 2012. Role of neutrophil/lymphocyte ratio in prediction of disease progression in patients with stage-4 chronic kidney disease. J. Nephrol. 2, 358-65.
• Muhmmed Suliman, M.A., Bahnacy Juma, A.A., Ali Almadhani, A.A., Pathare, A.V., Alkindi, S.S., Uwe Werner, F., 2010. Predictiv value of neutrophil to lymphocyte ratio in outcomes of patients with acute coronary syndrome. Arch. Med. Res. 41, 618-622.
• National Kidney Foundation., 2003. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am. J. Kidney. Dis. 42, 1-201.
• Noh, H., Lee, S.W., Kang, S.W., Shin, S.K., Choi, K.H., Lee, H.Y., Han, D.S., 1998. Serum C-reactive protein: A predictor of mortality in continuous ambulatory peritoneal dialysis patients. Perit. Dial. Int. 18, 387-394.
• Nşñez, J., Nşñez, E., Bodí, V., Sanchis, J., Miñana, G., Mainar, L., Santas, E., Merlos, P., Rumiz, E., Darmofal, H., Heatta, A.M., Llàcer, A.. 200 Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am. J. Cardiol. 101, 747-752. Owen, W.F., Lowrie, E.G., 1998. C-reactive protein as an outcome predictor for maintenance hemodialysis patients. Kidney. Int. 54, 627-636.
• Pecoits-Filho, R., Lindholm, B., Stenvinkel, P., 2002. The malnutrition, inflammation, and atherosclerosis (MIA) syndrome - the heart of the Erdem et al.