Neutrophil to Lymphocyte Ratio as a Predictor of Long-Term Outcome in Peritoneal Dialysis Patients: A 5-Year Cohort Study
Neutrophil to Lymphocyte Ratio as a Predictor of Long-Term Outcome in Peritoneal Dialysis Patients: A 5-Year Cohort Study
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DOI：
10.1159/000510552
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发表时间：
2021-01-28
影响因子：
3
通讯作者：
Ji, Jun
中科院分区：
文献类型：
--
作者：
Zhang, Lin;Nie, Yuxin;Ji, Jun
前言：腹膜透析(PD)患者的死亡率居高不下。中性粒细胞/淋巴细胞比率(NLR)作为全身炎症的指标，已被认为是血液透析患者心血管和全因死亡率的预测因子。本研究旨在探讨NLR与PD患者远期预后的关系。材料和方法：该研究包括2013年1月1日至2015年12月31日期间至少3个月开始进行PD的患者。对所有患者进行随访，直至死亡、帕金森病停止或研究结束(2018年6月31日)。用中性粒细胞与淋巴细胞的比值计算NLR。结果：本研究共纳入140例患者。NLR报告的中位数为2.87。NLR值低的患者存活率高于NLR值高的患者(LOG等级6.886，p=0.009)。此外，NLR值越高的患者心血管死亡率越高(LOG排名5.221，p=0.022)。多因素COX比例风险模型显示，高龄(HR 1.054，95%CI 1.017~1.092，p=0.004)、高钙磷(HR 1.689，95%CI 1.131~2.523，p=0.010)和高NLR(HR 2.603，95%CI 1.037~6.535，p=0.042)是全因死亡率增加的独立预测因素。NLR也与心血管死亡率独立相关(HR 2.886，95%CI 1.005-8.283，p=0.039)。较高的NLR值(HR 2.667，95%CI 1.333~5.337，p=0.006)、高龄(HR 1.028，95%CI 1.005~1.052，p=0.016)和心血管病史(HR 1.426，95%CI 1.195~3.927，p=0.016)与无腹膜炎生存率显著相关。结论：NLR可以很好地预测PD患者的长期预后。
Introduction: The mortality of peritoneal dialysis (PD) patients remains high. The neutrophil to lymphocyte ratio (NLR), as an indicator of systemic inflammation, has been considered to be a predictor of cardiovascular and all-cause mortality in hemodialysis patients. The present study aims to investigate the relationship between NLR and long-term outcome in PD patients. Materials and Methods: The study included patients who initiated PD for at least 3 months between January 1, 2013, and December 31, 2015. All the patients were followed up until death, cessation of PD, or to the end of the study (June 31, 2018). NLR was calculated as the ratio of neutrophils to lymphocytes. Results: A total of 140 patients were included in this study. The median NLR reported was 2.87. Patients with lower NLR showed a higher survival rate than patients with higher NLR (log rank 6.886, p = 0.009). Furthermore, patients with higher NLR had a significantly higher cardiovascular mortality (log rank 5.221, p = 0.022). Multivariate Cox proportional hazards model showed that older age (HR 1.054, 95% CI 1.017-1.092, p = 0.004), higher Ca x P (HR 1.689, 95% CI 1.131-2.523, p = 0.010), and higher NLR (HR 2.603, 95% CI 1.037-6.535, p = 0.042) were independent predictors of increased all-cause mortality. NLR was also independently associated with cardiovascular mortality (HR 2.886, 95% CI 1.005-8.283, p = 0.039). Higher NLR (HR 2.667, 95% CI 1.333-5.337, p = 0.006), older age (HR 1.028, 95% CI 1.005-1.052, p = 0.016), and history of cardiovascular disease (HR 1.426, 95% CI 1.195-3.927, p = 0.031) were significantly independently associated with poor peritonitis-free survival in this study. Conclusions: NLR could be a strong predictor of long-term outcome in PD patients.