Abstract: PUB204
Comparative Study on the Value of Blood Cellular Indices in Predicting ESRD Outcomes
Session Information
Category: Pathology and Lab Medicine
- 1700 Pathology and Lab Medicine
Authors
- Nunez, Roy D., Loyola University Medical Center, Chicago, Illinois, United States
- Vellanki, Kavitha, Loyola University Medical Center, Chicago, Illinois, United States
- Bansal, Vinod K., Loyola University Medical Center, Chicago, Illinois, United States
- Fareed, Jawed, Loyola University Medical Center, Chicago, Illinois, United States
Background
End Stage Renal Disease (ESRD) affected ~808,000 Americans in 2023, with mortality rates rising since 2020. ESRD is defined by severe renal dysfunction (GFR <15 mL/min), causing impaired filtration, anemia, and toxin buildup. Complete Blood Counts (CBCs) provide blood cellular indices that act as hematopoietic markers. Changes may reflect ESRD-associated cardiovascular and inflammatory complications.
Methods
This retrospective study compared blood cellular indices between 67 ESRD hemodialysis patients and 102 healthy controls. Clinical variables included diabetes, COVID-19, cancer, deep vein thrombosis, pulmonary embolism, acute coronary syndrome, heart failure, stroke, myocardial infarction, and smoking.
Indices included neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-monocyte ratio (PMR), lymphocyte-to-red blood cell ratio (LRR), neutrophil-to-red blood cell ratio (NRR), monocyte-to-red blood cell ratio (MRR), systemic immune inflammation index (SII), and systemic immune response index (SIRI). Data were summarized as median (IQR). Mann-Whitney and Spearman correlations evaluated associations with clinical variables and cohorts.
Results
The ESRD cohort had a median age of 65 years with equal sex distribution. Common comorbidities included diabetes, COVID-19, HF, cancer, DVT, and ACS. All blood cellular indices except PLR differed significantly between cohorts. ESRD patients showed elevated NLR, dNLR, SIRI, MLR, LRR, SII, NRR, and MRR. Significant correlations reflected cardiovascular and thromboembolic complications.
Conclusion
Comorbidity stratification showed minimal influence on blood cellular indices. MLR and LRR differed in smokers, PMR differed in HF patients. These findings suggest blood cellular indices remain stable across most comorbid conditions and may serve as robust non-invasive biomarkers for ESRD-associated complications.
Acknowledgment
We are thankful to the Loyola Univeristy Medical Center hemodialysis unit staff for the collection of blood samples from patients. We are also thankful to Dr. Omer Iqbal for his helpful suggestions during the study. We are grateful to Dr. Eva Wojcik for her support during this study. A special thanks are extended to Dr. Singh for his facilitation of this study.