Abstract: SA-PO935
Higher Neutrophil to Lymphocyte Ratio (NLR) Associates with Poor Clinical Outcome Independent of Traditional Factors in Peritoneal Dialysis Patients
Session Information
- Peritoneal Dialysis: Inflammation, Peritoneal Transport
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Zhimin, Chen, Zhejiang University, Hang Zhou, China
- Qureshi, Abdul Rashid Tony, Karolinska Institutet, Huddinge, Stockholm, Sweden
- Han, Fei, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ZHEJIANG, China
- Xie, Xishao, Kidney Disease Center, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China
- Stenvinkel, Peter, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Lindholm, Bengt, Karolinska Institutet, Huddinge, Stockholm, Sweden
- Zhang, Xiaohui, Zhejiang University, Hangzhou, China
- Chen, Jianghua, Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ZHEJIANG, China
Background
Neutrophil to lymphocyte ratio (NLR) is an inexpensive and widely available biomarker of inflammation that predicts clinical outcomes in dialysis patients. However, the association between NLR and mortality among patients treated with peritoneal dialysis (PD) is not fully explored.
Methods
In 767 incident PD patients (median age 50 years, 57 % males, 15% diabetes and 6% cardiovascular disease, CVD), baseline NLR andother metabolic biomarkers potentially linked to CVD were analysedin relation to mortality during follow up period of up to 60 months. All-cause and cardiovascular mortality risk associated with NLRwere analyzed with competing-risk regression models with transplantation as competing risk, adjusting for all investigated covariates.
Results
Patients with highest tertile of NLR were older, had higher creatinine and BMI and low serum albumin and parathyroid hormone (iPTH). In univariate analysis, NLR associated with white blood cell count (rho=-0.33, p=0.001), age (rho=0.10, p=0.01), calcium (rho=-0.10, p=0.01), iPTH (rho=0.09, p=0.01) and C-reactive protein (n=644; rho=0.10, p=0.01). Highest tertile of NLR associated with high all-cause mortality risk compared with low + middle tertiles, sub-hazard ratio (sHR) of 1.79 (95% CI, 1.18-2.73; p=0.006), and high CVD mortality risk, sHR 1.55 (95% CI, 0.85-2.85; p=0.01) after adjusting for Framingham’s score, presence of CVD, circulating levels of uric acid, creatinine, calcium, phosphate, Hb, iPTH, alkaline phosphatase, ALAT and ASAT, and calendar year of recruitment.
Conclusion
In patients undergoing PD, higher NLR was associated with increased all-cause mortality risk, independently of Framingham’s risk score and additional confounders, suggesting that this biomarker of inflammation is a useful prognostic tool in PD patients.