Neutrophil-to-lymphocyte ratio as a predictor for early mortality in older patients requiring hemodialysis; insights for hemodialysis access planning
Abstract Introduction The 2019 Kidney Disease Outcome Quality Initiative guidelines emphasize the importance of selecting dialysis based on the life expectancy of the patient. However, it is difficult to predict the life expectancy of a patient during arteriovenous fistula creation. We investigated...
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2025-01-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-024-03924-0 |
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| author | Hyo Kee Kim Heungman Jun Sun-Young Ko |
| author_facet | Hyo Kee Kim Heungman Jun Sun-Young Ko |
| author_sort | Hyo Kee Kim |
| collection | DOAJ |
| description | Abstract Introduction The 2019 Kidney Disease Outcome Quality Initiative guidelines emphasize the importance of selecting dialysis based on the life expectancy of the patient. However, it is difficult to predict the life expectancy of a patient during arteriovenous fistula creation. We investigated whether neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios measured before dialysis could predict mortality. Materials and methods Between January 2016 and December 2020, we retrospectively analyzed electronic medical records of 448 patients aged ≥ 70 years undergoing first-time arteriovenous access surgery at three tertiary care hospitals, all of whom had not received prior dialysis treatment. Only patients undergoing blood tests on the day before surgery were included in the analysis. Patients who died within one year after surgery were included in the non-survival group, while those who died after one year were included in the survival group. Results Patients were categorized into non-survival (n = 52) and survival (n = 396) groups. Multivariate analysis for one-year mortality revealed that the preoperative neutrophil-to-lymphocyte ratio demonstrated a 1.15 hazard ratio ( p < 0.001 ). Also, cancer (HR 2.50, p = 0.02) and peripheral arterial disease (HR 4.62, p < 0.001) were risk factor for one-year mortality. The preoperative platelet-to-lymphocyte and monocyte-to-lymphocyte ratios were not identified as one-year mortality risk factors. In the total mortality multivariate analysis, monocyte-to-lymphocyte ratios were one of the risk factors (HR 2.74, p < 0.007). Conclusion The neutrophil-to-lymphocyte ratio was a risk factor associated with one-year mortality in patients aged ≥ 70 years. However, further research is required to determine whether these can be used for predictive purposes. |
| format | Article |
| id | doaj-art-614ec6250410410d88929fb9df169d56 |
| institution | Kabale University |
| issn | 1471-2369 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Nephrology |
| spelling | doaj-art-614ec6250410410d88929fb9df169d562025-01-05T12:11:04ZengBMCBMC Nephrology1471-23692025-01-012611610.1186/s12882-024-03924-0Neutrophil-to-lymphocyte ratio as a predictor for early mortality in older patients requiring hemodialysis; insights for hemodialysis access planningHyo Kee Kim0Heungman Jun1Sun-Young Ko2Department of Surgery, Korea University Guro Hospital, Korea University College of MedicineDepartment of Surgery, Korea University Anam Hospital, Korea University College of MedicineDepartment of Laboratory Medicine, Korea University Ansan Hospital, Korea University College of MedicineAbstract Introduction The 2019 Kidney Disease Outcome Quality Initiative guidelines emphasize the importance of selecting dialysis based on the life expectancy of the patient. However, it is difficult to predict the life expectancy of a patient during arteriovenous fistula creation. We investigated whether neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios measured before dialysis could predict mortality. Materials and methods Between January 2016 and December 2020, we retrospectively analyzed electronic medical records of 448 patients aged ≥ 70 years undergoing first-time arteriovenous access surgery at three tertiary care hospitals, all of whom had not received prior dialysis treatment. Only patients undergoing blood tests on the day before surgery were included in the analysis. Patients who died within one year after surgery were included in the non-survival group, while those who died after one year were included in the survival group. Results Patients were categorized into non-survival (n = 52) and survival (n = 396) groups. Multivariate analysis for one-year mortality revealed that the preoperative neutrophil-to-lymphocyte ratio demonstrated a 1.15 hazard ratio ( p < 0.001 ). Also, cancer (HR 2.50, p = 0.02) and peripheral arterial disease (HR 4.62, p < 0.001) were risk factor for one-year mortality. The preoperative platelet-to-lymphocyte and monocyte-to-lymphocyte ratios were not identified as one-year mortality risk factors. In the total mortality multivariate analysis, monocyte-to-lymphocyte ratios were one of the risk factors (HR 2.74, p < 0.007). Conclusion The neutrophil-to-lymphocyte ratio was a risk factor associated with one-year mortality in patients aged ≥ 70 years. However, further research is required to determine whether these can be used for predictive purposes.https://doi.org/10.1186/s12882-024-03924-0NLRHemodialysisSurvivalVascular access |
| spellingShingle | Hyo Kee Kim Heungman Jun Sun-Young Ko Neutrophil-to-lymphocyte ratio as a predictor for early mortality in older patients requiring hemodialysis; insights for hemodialysis access planning BMC Nephrology NLR Hemodialysis Survival Vascular access |
| title | Neutrophil-to-lymphocyte ratio as a predictor for early mortality in older patients requiring hemodialysis; insights for hemodialysis access planning |
| title_full | Neutrophil-to-lymphocyte ratio as a predictor for early mortality in older patients requiring hemodialysis; insights for hemodialysis access planning |
| title_fullStr | Neutrophil-to-lymphocyte ratio as a predictor for early mortality in older patients requiring hemodialysis; insights for hemodialysis access planning |
| title_full_unstemmed | Neutrophil-to-lymphocyte ratio as a predictor for early mortality in older patients requiring hemodialysis; insights for hemodialysis access planning |
| title_short | Neutrophil-to-lymphocyte ratio as a predictor for early mortality in older patients requiring hemodialysis; insights for hemodialysis access planning |
| title_sort | neutrophil to lymphocyte ratio as a predictor for early mortality in older patients requiring hemodialysis insights for hemodialysis access planning |
| topic | NLR Hemodialysis Survival Vascular access |
| url | https://doi.org/10.1186/s12882-024-03924-0 |
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