Yaprak Mustafa, Turan Mehmet Nuri, Dayanan Ramazan, Akın Selçuk, Değirmen Elif, Yıldırım Mustafa, Turgut Faruk
Division of Nephrology, Department of Internal Medicine, School of Medicine, Mustafa Kemal University, 31100, Antakya, Hatay, Turkey.
Division of Nephrology, Department of Internal Medicine, School of Medicine, Harran University, Urfa, Turkey.
Int Urol Nephrol. 2016 Aug;48(8):1343-1348. doi: 10.1007/s11255-016-1301-4. Epub 2016 Apr 27.
Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were established showing the poor prognosis in some diseases, such as cardiovascular diseases and malignancies. The risk of mortality in patients with end-stage renal disease (ESRD) was higher than normal population. In this study, we aimed to investigate the relationship between NLR, PLR, and all-cause mortality in prevalent hemodialysis (HD) patients.
Eighty patients were enrolled in study. NLR and PLR obtained by dividing absolute neutrophil to absolute lymphocyte count and absolute platelet count to absolute lymphocyte count, respectively. The patients were followed prospectively for 24 months. The primary end point was all-cause mortality.
Mean levels of neutrophil, lymphocyte, and platelet were 3904 ± 1543/mm(3), 1442 ± 494/mm(3), 174 ± 56 × 10(3)/mm(3), respectively. Twenty-one patients died before the follow-up at 24 months. Median NLR and PLR were 2.52 and 130.4, respectively. All-cause mortality was higher in patients with high NLR group compared to the patients with low NLR group (18.8 vs. 7.5 %, p = 0.031) and in patients with higher PLR group compared to patients with lower PLR group (18.8 vs. 7.5 %, p = 0.022). Following adjusted Cox regression analysis, the association of mortality and high NLR was lost (p = 0.54), but the significance of the association of high PLR and mortality increased (p = 0.013).
Although both NLR and PLR were associated with all-cause mortality in prevalent HD patients, only PLR could independently predict all-cause mortality in these populations.
中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)已被证实与某些疾病(如心血管疾病和恶性肿瘤)的不良预后相关。终末期肾病(ESRD)患者的死亡风险高于正常人群。在本研究中,我们旨在探讨NLR、PLR与维持性血液透析(HD)患者全因死亡率之间的关系。
80例患者纳入研究。NLR通过绝对中性粒细胞计数除以绝对淋巴细胞计数获得,PLR通过绝对血小板计数除以绝对淋巴细胞计数获得。对患者进行前瞻性随访24个月。主要终点为全因死亡率。
中性粒细胞、淋巴细胞和血小板的平均水平分别为3904±1543/mm³、1442±494/mm³、174±56×10³/mm³。21例患者在24个月的随访前死亡。NLR和PLR的中位数分别为2.52和130.4。高NLR组患者的全因死亡率高于低NLR组患者(18.8%对7.5%,p = 0.031),高PLR组患者的全因死亡率高于低PLR组患者(18.8%对7.5%,p = 0.022)。经过校正的Cox回归分析后,高NLR与死亡率的关联消失(p = 0.54),但高PLR与死亡率关联的显著性增加(p = 0.013)。
虽然NLR和PLR均与维持性HD患者的全因死亡率相关,但只有PLR能够独立预测这些人群的全因死亡率。