ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO768

Neutrophils to Lymphocytes Ratio Prior to Death in Hemodialysis Patients: Results from the Global MONDO Initiative

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Ye, Xiaoling, Renal Research Institute, New York, New York, United States
  • Yousif, Dalia Elrashid M, Renal Research Institute, New York, New York, United States
  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States
  • Wang, Yuedong, University of California - Santa Barbara, Santa Barbara, California, United States
  • Kooman, Jeroen, Maastricht University Medical Centre, Maastricht, Netherlands
  • van der Sande, Frank, Maastricht University Medical Centre, Maastricht, Netherlands
  • Stuard, Stefano, Fresenius Medical Care, Bad Homburg, Germany
  • Canaud, Bernard J., FMC Deutschland GmbH, Bad Homburg, Germany
  • Guinsburg, Adrian M., Fresenius Medical Care, Bad Homburg, Germany
  • Usvyat, Len A., Fresenius Medical Care North America, Melrose, Massachusetts, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States

Group or Team Name

  • The MONDO Initiative
Background

Among patients(pts) with end stage renal disease (ESRD), chronic inflammation is highly prevalent and associated with adverse clinical outcomes including CVD and death. Understanding the dynamics of readily available inflammatory markers (NLR,CRP,WBC) across different survival time is an essential way to explore patient- and process-related factors that contribute to adverse outcomes.

Methods

MONDO Initiative is a global retrospective cohort study that contained data of 150k+ pts with in-center HD from 41 countries&6 continents. Adult pts who died within the first 36 months (mos) on HD were stratified into 6 groups, pts died from 0-6, 6-12,12-18,18-24,24-30 and 30-36 mos after HD initiation. Pts who survived 36+ mos were chosen as the control group. Monthly average of NLR, CRP, Neutrophils, Lymphocytes, WBC were obtained, cubic spline function were applied to access the trends and rate of changes for each of the parameters of interest. Additionly, subgroup analysis were performed to explore the sex and regional differences.

Results

18,276 incident HD pts were included, 2,068 died within 6 mos,1,231 died 6 -12 mos,971 died 12 -18 mos,792 died 18-24 mos,721 died 24-30 mos, 648 died 30-36 mos, and 12,295 survived 36+ mos. For pts who with shorter survival time, NLR, Neutrophils, Lymphocytes, WBC&CRP were observed to be higher at HD initiation. Additionaly, all the inflammatory markers were declined after the HD initiation and reached nadir from 3-0 mo, vary by pts' survival time. All the markers with an accrelated trend mos before death. For pts who survived 36+ mos, NLR, CRP and WBC seem to be stable after they reached the nadir. No sex and regional differences were observed.

Conclusion

Understanding the dynamics of readily available inflammatory markers is an important way to explore patient- and process-related factors that contribute to outcomes. NLR variations over survival time may have a prognostic impact.