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Association of monocyte-to-lymphocyte ratio and practical nutritional indicators in peritoneal dialysis patients

Yıl 2024, Cilt: 38 Sayı: 3, 179 - 188, 27.12.2024
https://doi.org/10.18614/deutip.1424254

Öz

Background: This study aimed to analyze the association between monocyte-to-lymphocyte ratio (MLR) and nutritional indicators in peritoneal dialysis (PD) patients
Methods: Among the 228 maintenance PD patients 44 of those were included in this retrospective analysis. The geriatric nutrition risk index (GNRI) was calculated by using serum albumin and body weight, and the prognostic nutrition index (PNI) was by serum albumin and lymphocyte count. Monocyte-to-lymphocyte ratio (MLR) and nutritional indicators were analyzed by Spearman correlation and linear regression analysis.
Results: During the follow-up of 25 months, median GNRI and PNI values showed an increase from a median baseline GNRI of 86.7 (IQR, 92.9, 104.9) to 100.5 (IQR, 92.7, 109.0) (p=0.03) and PNI values of baseline 43.1 (IQR, 41.0, 46.3) to 46.1 (IQR, 39.1, 50.5) (p=0.02). MLR showed a decrease from the baseline median value of 0.38 (IQR, 0.28, 0.58) to 0.36 (IQR, 0.29, 0.47) p=0.03. There were no changes in leukocyte and hs-CRP levels. There were statistically significant negative correlations between MLR and PNI (rs -0.452; p=0.002), GNRI (rs -0.400 p=0.008), and BMI (rs -0.308; p=0.04). No significant correlation was observed with albumin levels (rs =0.221; p=0.154). MLR was statistically significantly associated with GNRI, PNI, and body mass index (BMI) except albumin, however, hs-CRP level was only associated with serum albumin in both univariate and multivariate regression analysis.
Conclusion: This study indicates that the higher MLR values were associated with lower GNRI and PNI values in PD patients. MLR may help clinicians to identify the nutritional status of this population.

Kaynakça

  • 1. Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, Fouque D, Friedman AN, Ghaddar S, Goldstein-Fuchs DJ, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020;76:S1-S107. doi: 10.1053/j.ajkd.2020.05.006
  • 2. Kamijo Y, Kanda E, Ishibashi Y, Yoshida M. Sarcopenia and Frailty in PD: Impact on Mortality, Malnutrition, and Inflammation. Perit Dial Int. 2018;38:447-454. doi: 10.3747/pdi.2017.00271
  • 3. Steiber AL, Kalantar-Zadeh K, Secker D, McCarthy M, Sehgal A, McCann L. Subjective Global Assessment in chronic kidney disease: a review. J Ren Nutr. 2004;14:191-200.
  • 4. Ikizler TA, Cano NJ, Franch H, Fouque D, Himmelfarb J, Kalantar-Zadeh K, Kuhlmann MK, Stenvinkel P, TerWee P, Teta D, et al. Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism. Kidney Int. 2013;84:1096-1107. doi: 10.1038/ki.2013.147
  • 5. Bouillanne O, Morineau G, Dupont C, Coulombel I, Vincent JP, Nicolis I, Benazeth S, Cynober L, Aussel C. Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr. 2005;82:777-783. doi: 10.1093/ajcn/82.4.777
  • 6. Yildirim F, Uzun O, Nasuhbeyoglu G, Narlioglu A, Bildaci YD, Cavdar C, Deger SM. The association between geriatric nutritional risk index variability and mortality in peritoneal dialysis patients. Ther Apher Dial. 2023. doi: 10.1111/1744-9987.13984
  • 7. Ebinc FA, Okyay GU, Deger SM, Sahin H, Selen T, Dpgan CK, Atilgan KG, Cguz EG, Ayli MD. Comparison of geriatric nutritional risk index and creatinine index in short-term mortality prediction in maintenance hemodialysis patients. Turk J Med Sci. 2022;52:641-648. doi: 10.55730/1300-0144.5356
  • 8. Kang SH, Cho KH, Park JW, Yoon KW, Do JY. Geriatric Nutritional Risk Index as a prognostic factor in peritoneal dialysis patients. Perit Dial Int. 2013;33:405-410. doi: 10.3747/pdi.2012.00018
  • 9. Kanda M, Fujii T, Kodera Y, Nagai S, Takeda S, Nakao A. Nutritional predictors of postoperative outcome in pancreatic cancer. Br J Surg. 2011;98:268-274. doi: 10.1002/bjs.7305
  • 10. Mohri T, Mohri Y, Shigemori T, Takeuchi K, Itoh Y, Kato T. Impact of prognostic nutritional index on long-term outcomes in patients with breast cancer. World J Surg Oncol. 2016;14:170. doi: 10.1186/s12957-016-0920-7
  • 11. Cai L, Yu J, Yu J, Peng Y, Ullah H, Yi C, Lin J, Yang X, Yu X. Prognostic value of inflammation-based prognostic scores on outcome in patients undergoing continuous ambulatory peritoneal dialysis. BMC Nephrol. 2018;19:297. doi: 10.1186/s12882-018-1092-1
  • 12. Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, Franch H, Guarnieri G, Ikizler TA, Kaysen G, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73:391-398. doi: 10.1038/sj.ki.5002585
  • 13. Avram MM, Fein PA, Rafiq MA, Schloth T, Chattopadhyay J, Mittman N. Malnutrition and inflammation as predictors of mortality in peritoneal dialysis patients. Kidney International. 2006;70:S4-S7. doi: 10.1038/sj.ki.5001968
  • 14. Wen Y, Zhan X, Wang N, Peng F, Feng X, Wu X. Monocyte/Lymphocyte Ratio and Cardiovascular Disease Mortality in Peritoneal Dialysis Patients. Mediators Inflamm. 2020;2020:9852507. doi: 10.1155/2020/9852507
  • 15. Yang Y, Xu Y, Lu P, Zhou H, Yang M, Xiang L. The prognostic value of monocyte-to-lymphocyte ratio in peritoneal dialysis patients. Eur J Med Res. 2023;28:152. doi: 10.1186/s40001-023-01073-y
  • 16. Onodera T, Goseki N, Kosaki G. [Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients]. Nihon Geka Gakkai Zasshi. 1984;85:1001-1005.
  • 17. Satirapoj B, Limwannata P, Kleebchaiyaphum C, Prapakorn J, Yatinan U, Chotsriluecha S, Supasyndh O. Nutritional status among peritoneal dialysis patients after oral supplement with ONCE dialyze formula. Int J Nephrol Renov. 2017;10:145-151. doi: 10.2147/Ijnrd.S138047
  • 18. Lawson JA, Lazarus R, Kelly JJ. Prevalence and prognostic significance of malnutrition in chronic renal insufficiency. J Ren Nutr. 2001;11:16-22. doi: 10.1016/s1051-2276(01)85914-8
  • 19. Stenvinkel P, Lindholm B, Heimburger O. New strategies for management of malnutrition in peritoneal dialysis patients. Perit Dial Int. 2000;20:271-275.
  • 20. Tokunaga R, Sakamoto Y, Nakagawa S, Miyamoto Y, Yoshida N, Oki E, Watanabe M, Baba H. Prognostic Nutritional Index Predicts Severe Complications, Recurrence, and Poor Prognosis in Patients With Colorectal Cancer Undergoing Primary Tumor Resection. Dis Colon Rectum. 2015;58:1048-1057. doi: 10.1097/DCR.0000000000000458
  • 21. Shang S, Huang Y, Zhan X, Peng F, Wang X, Wen Y, Feng X, Zhou Q, Tang LW, Long H, et al. The relationship between the prognostic nutritional index and new-onset pneumonia in peritoneal dialysis patients. Int Urol Nephrol. 2022;54:3017-3024. doi: 10.1007/s11255-022-03233-1
  • 22. Migita K, Takayama T, Saeki K, Matsumoto S, Wakatsuki K, Enomoto K, Tanaka T, Ito M, Kurumatani N, Nakajima Y. The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage. Ann Surg Oncol. 2013;20:2647-2654. doi: 10.1245/s10434-013-2926-5
  • 23. Kang SH, Cho KH, Park JW, Yoon KW, Do JY. Onodera's prognostic nutritional index as a risk factor for mortality in peritoneal dialysis patients. J Korean Med Sci. 2012;27:1354-1358. doi: 10.3346/jkms.2012.27.11.1354
  • 24. Yang Y, Xu YY, Zhang P, Zhou H, Yang M, Xiang L. Predictive Value of Objective Nutritional Indexes in Technique Failure in Peritoneal Dialysis Patients. J Renal Nutr. 2022;32:605-612. doi: 10.1053/j.jrn.2021.09.005
  • 25. Lee MJ, Kwon YE, Park KS, Park JT, Han SH, Kang SW, Kim HJ, Yoo TH. Changes in geriatric nutritional risk index and risk of major adverse cardiac and cerebrovascular events in incident peritoneal dialysis patients. Kidney Res Clin Pract. 2017;36:377-386. doi: 10.23876/j.krcp.2017.36.4.377
  • 26. Peng SM, Yu N, Ren JJ, Xu JY, Chen GC, Yang JR, Li ZN, Du HZ, Li DP, Zhang YS, et al. The Geriatric Nutritional Risk Index as a Prognostic Factor in Patients with Advanced Non-Small-Cell Lung Cancer. Nutr Cancer. 2021;73:2832-2841. doi: 10.1080/01635581.2020.1865423
  • 27. Panichi V, Cupisti A, Rosati A, Di Giorgio A, Scatena A, Menconi O, Bozzoli L, Bottai A. Geriatric nutritional risk index is a strong predictor of mortality in hemodialysis patients: data from the Riscavid cohort. J Nephrol. 2014;27:193-201. doi: 10.1007/s40620-013-0033-0
  • 28. Xiang J, Zhou L, Li X, Bao W, Chen T, Xi X, He Y, Wan X. Preoperative Monocyte-to-Lymphocyte Ratio in Peripheral Blood Predicts Stages, Metastasis, and Histological Grades in Patients with Ovarian Cancer. Transl Oncol. 2017;10:33-39. doi: 10.1016/j.tranon.2016.10.006
  • 29. Xiang F, Chen R, Cao X, Shen B, Liu Z, Tan X, Ding X, Zou J. Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all-cause mortality in hemodialysis patients: A prospective cohort study. Hemodial Int. 2018;22:82-92. doi: 10.1111/hdi.12549

Association of monocyte-to-lymphocyte ratio and practical nutritional indicators in peritoneal dialysis patients

Yıl 2024, Cilt: 38 Sayı: 3, 179 - 188, 27.12.2024
https://doi.org/10.18614/deutip.1424254

Öz

Background: This study aimed to analyze the association between monocyte-to-lymphocyte ratio (MLR) and nutritional indicators in peritoneal dialysis (PD) patients
Methods: Among the 228 maintenance PD patients 44 of those were included in this retrospective analysis. The geriatric nutrition risk index (GNRI) was calculated by using serum albumin and body weight, and the prognostic nutrition index (PNI) was by serum albumin and lymphocyte count. Monocyte-to-lymphocyte ratio (MLR) and nutritional indicators were analyzed by Spearman correlation and linear regression analysis.
Results: During the follow-up of 25 months, median GNRI and PNI values showed an increase from a median baseline GNRI of 86.7 (IQR, 92.9, 104.9) to 100.5 (IQR, 92.7, 109.0) (p=0.03) and PNI values of baseline 43.1 (IQR, 41.0, 46.3) to 46.1 (IQR, 39.1, 50.5) (p=0.02). MLR showed a decrease from the baseline median value of 0.38 (IQR, 0.28, 0.58) to 0.36 (IQR, 0.29, 0.47) p=0.03. There were no changes in leukocyte and hs-CRP levels. There were statistically significant negative correlations between MLR and PNI (rs -0.452; p=0.002), GNRI (rs -0.400 p=0.008), and BMI (rs -0.308; p=0.04). No significant correlation was observed with albumin levels (rs =0.221; p=0.154). MLR was statistically significantly associated with GNRI, PNI, and body mass index (BMI) except albumin, however, hs-CRP level was only associated with serum albumin in both univariate and multivariate regression analysis.
Conclusion: This study indicates that the higher MLR values were associated with lower GNRI and PNI values in PD patients. MLR may help clinicians to identify the nutritional status of this population.

Kaynakça

  • 1. Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, Fouque D, Friedman AN, Ghaddar S, Goldstein-Fuchs DJ, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020;76:S1-S107. doi: 10.1053/j.ajkd.2020.05.006
  • 2. Kamijo Y, Kanda E, Ishibashi Y, Yoshida M. Sarcopenia and Frailty in PD: Impact on Mortality, Malnutrition, and Inflammation. Perit Dial Int. 2018;38:447-454. doi: 10.3747/pdi.2017.00271
  • 3. Steiber AL, Kalantar-Zadeh K, Secker D, McCarthy M, Sehgal A, McCann L. Subjective Global Assessment in chronic kidney disease: a review. J Ren Nutr. 2004;14:191-200.
  • 4. Ikizler TA, Cano NJ, Franch H, Fouque D, Himmelfarb J, Kalantar-Zadeh K, Kuhlmann MK, Stenvinkel P, TerWee P, Teta D, et al. Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism. Kidney Int. 2013;84:1096-1107. doi: 10.1038/ki.2013.147
  • 5. Bouillanne O, Morineau G, Dupont C, Coulombel I, Vincent JP, Nicolis I, Benazeth S, Cynober L, Aussel C. Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr. 2005;82:777-783. doi: 10.1093/ajcn/82.4.777
  • 6. Yildirim F, Uzun O, Nasuhbeyoglu G, Narlioglu A, Bildaci YD, Cavdar C, Deger SM. The association between geriatric nutritional risk index variability and mortality in peritoneal dialysis patients. Ther Apher Dial. 2023. doi: 10.1111/1744-9987.13984
  • 7. Ebinc FA, Okyay GU, Deger SM, Sahin H, Selen T, Dpgan CK, Atilgan KG, Cguz EG, Ayli MD. Comparison of geriatric nutritional risk index and creatinine index in short-term mortality prediction in maintenance hemodialysis patients. Turk J Med Sci. 2022;52:641-648. doi: 10.55730/1300-0144.5356
  • 8. Kang SH, Cho KH, Park JW, Yoon KW, Do JY. Geriatric Nutritional Risk Index as a prognostic factor in peritoneal dialysis patients. Perit Dial Int. 2013;33:405-410. doi: 10.3747/pdi.2012.00018
  • 9. Kanda M, Fujii T, Kodera Y, Nagai S, Takeda S, Nakao A. Nutritional predictors of postoperative outcome in pancreatic cancer. Br J Surg. 2011;98:268-274. doi: 10.1002/bjs.7305
  • 10. Mohri T, Mohri Y, Shigemori T, Takeuchi K, Itoh Y, Kato T. Impact of prognostic nutritional index on long-term outcomes in patients with breast cancer. World J Surg Oncol. 2016;14:170. doi: 10.1186/s12957-016-0920-7
  • 11. Cai L, Yu J, Yu J, Peng Y, Ullah H, Yi C, Lin J, Yang X, Yu X. Prognostic value of inflammation-based prognostic scores on outcome in patients undergoing continuous ambulatory peritoneal dialysis. BMC Nephrol. 2018;19:297. doi: 10.1186/s12882-018-1092-1
  • 12. Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, Franch H, Guarnieri G, Ikizler TA, Kaysen G, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73:391-398. doi: 10.1038/sj.ki.5002585
  • 13. Avram MM, Fein PA, Rafiq MA, Schloth T, Chattopadhyay J, Mittman N. Malnutrition and inflammation as predictors of mortality in peritoneal dialysis patients. Kidney International. 2006;70:S4-S7. doi: 10.1038/sj.ki.5001968
  • 14. Wen Y, Zhan X, Wang N, Peng F, Feng X, Wu X. Monocyte/Lymphocyte Ratio and Cardiovascular Disease Mortality in Peritoneal Dialysis Patients. Mediators Inflamm. 2020;2020:9852507. doi: 10.1155/2020/9852507
  • 15. Yang Y, Xu Y, Lu P, Zhou H, Yang M, Xiang L. The prognostic value of monocyte-to-lymphocyte ratio in peritoneal dialysis patients. Eur J Med Res. 2023;28:152. doi: 10.1186/s40001-023-01073-y
  • 16. Onodera T, Goseki N, Kosaki G. [Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients]. Nihon Geka Gakkai Zasshi. 1984;85:1001-1005.
  • 17. Satirapoj B, Limwannata P, Kleebchaiyaphum C, Prapakorn J, Yatinan U, Chotsriluecha S, Supasyndh O. Nutritional status among peritoneal dialysis patients after oral supplement with ONCE dialyze formula. Int J Nephrol Renov. 2017;10:145-151. doi: 10.2147/Ijnrd.S138047
  • 18. Lawson JA, Lazarus R, Kelly JJ. Prevalence and prognostic significance of malnutrition in chronic renal insufficiency. J Ren Nutr. 2001;11:16-22. doi: 10.1016/s1051-2276(01)85914-8
  • 19. Stenvinkel P, Lindholm B, Heimburger O. New strategies for management of malnutrition in peritoneal dialysis patients. Perit Dial Int. 2000;20:271-275.
  • 20. Tokunaga R, Sakamoto Y, Nakagawa S, Miyamoto Y, Yoshida N, Oki E, Watanabe M, Baba H. Prognostic Nutritional Index Predicts Severe Complications, Recurrence, and Poor Prognosis in Patients With Colorectal Cancer Undergoing Primary Tumor Resection. Dis Colon Rectum. 2015;58:1048-1057. doi: 10.1097/DCR.0000000000000458
  • 21. Shang S, Huang Y, Zhan X, Peng F, Wang X, Wen Y, Feng X, Zhou Q, Tang LW, Long H, et al. The relationship between the prognostic nutritional index and new-onset pneumonia in peritoneal dialysis patients. Int Urol Nephrol. 2022;54:3017-3024. doi: 10.1007/s11255-022-03233-1
  • 22. Migita K, Takayama T, Saeki K, Matsumoto S, Wakatsuki K, Enomoto K, Tanaka T, Ito M, Kurumatani N, Nakajima Y. The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage. Ann Surg Oncol. 2013;20:2647-2654. doi: 10.1245/s10434-013-2926-5
  • 23. Kang SH, Cho KH, Park JW, Yoon KW, Do JY. Onodera's prognostic nutritional index as a risk factor for mortality in peritoneal dialysis patients. J Korean Med Sci. 2012;27:1354-1358. doi: 10.3346/jkms.2012.27.11.1354
  • 24. Yang Y, Xu YY, Zhang P, Zhou H, Yang M, Xiang L. Predictive Value of Objective Nutritional Indexes in Technique Failure in Peritoneal Dialysis Patients. J Renal Nutr. 2022;32:605-612. doi: 10.1053/j.jrn.2021.09.005
  • 25. Lee MJ, Kwon YE, Park KS, Park JT, Han SH, Kang SW, Kim HJ, Yoo TH. Changes in geriatric nutritional risk index and risk of major adverse cardiac and cerebrovascular events in incident peritoneal dialysis patients. Kidney Res Clin Pract. 2017;36:377-386. doi: 10.23876/j.krcp.2017.36.4.377
  • 26. Peng SM, Yu N, Ren JJ, Xu JY, Chen GC, Yang JR, Li ZN, Du HZ, Li DP, Zhang YS, et al. The Geriatric Nutritional Risk Index as a Prognostic Factor in Patients with Advanced Non-Small-Cell Lung Cancer. Nutr Cancer. 2021;73:2832-2841. doi: 10.1080/01635581.2020.1865423
  • 27. Panichi V, Cupisti A, Rosati A, Di Giorgio A, Scatena A, Menconi O, Bozzoli L, Bottai A. Geriatric nutritional risk index is a strong predictor of mortality in hemodialysis patients: data from the Riscavid cohort. J Nephrol. 2014;27:193-201. doi: 10.1007/s40620-013-0033-0
  • 28. Xiang J, Zhou L, Li X, Bao W, Chen T, Xi X, He Y, Wan X. Preoperative Monocyte-to-Lymphocyte Ratio in Peripheral Blood Predicts Stages, Metastasis, and Histological Grades in Patients with Ovarian Cancer. Transl Oncol. 2017;10:33-39. doi: 10.1016/j.tranon.2016.10.006
  • 29. Xiang F, Chen R, Cao X, Shen B, Liu Z, Tan X, Ding X, Zou J. Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all-cause mortality in hemodialysis patients: A prospective cohort study. Hemodial Int. 2018;22:82-92. doi: 10.1111/hdi.12549
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Araştırma Makaleleri
Yazarlar

Aysu Okumuş 0000-0001-9662-574X

Yelda Deligöz Bildacı 0000-0001-9888-995X

Mehmet Ası Oktan 0000-0002-9322-5844

Caner Çavdar 0000-0002-2306-2429

Serpil Müge Değer 0000-0002-7635-2382

Yayımlanma Tarihi 27 Aralık 2024
Gönderilme Tarihi 23 Ocak 2024
Kabul Tarihi 20 Eylül 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 38 Sayı: 3

Kaynak Göster

Vancouver Okumuş A, Deligöz Bildacı Y, Oktan MA, Çavdar C, Değer SM. Association of monocyte-to-lymphocyte ratio and practical nutritional indicators in peritoneal dialysis patients. DEU Tıp Derg. 2024;38(3):179-88.