Uludag Koray, Arikan Tamer
Department of Internal Medicine, Nephrology Division, Health Sciences University, Kayseri Medical Faculty, Kayseri City Hospital, Kayseri, TUR.
Cureus. 2021 Nov 18;13(11):e19728. doi: 10.7759/cureus.19728. eCollection 2021 Nov.
Objective White blood cell (WBC) count was used as a predictor in researches since it is a prognostic indicator and a substantial predictor of the development of cardiovascular disease (CVD). There have been very few reports looking at the association between WBC count and overall mortality in peritoneal dialysis (PD) patients. We intended to explore if the baseline total leukocyte count is linked to all-cause mortality, considering the association for linearity in PD patients. Material and methods The study comprised 204 incident PD patients who began treatment at the Nephrology Department of Health Sciences University, Kayseri Medical Faculty, Kayseri City Hospital between January 2009 and December 2017. The research period ended in January 2018. The link between baseline WBC count and all-cause mortality was studied using Cox proportional hazards models. Results The average age of the patients was 46.75 (8.49) years, and 48.5% were male. Diabetes and hypertension were prevalent in 59.8% and 76% of the population, respectively. The average WBC count was 9.37 (2.70) × 10/µL. The mortality risk increased by 23% for every one-unit increase in the crude model. The hazard of death in the fully corrected model was 1.12 [95% confidence interval (CI): 1.02-1.23, p = 0.015]. In the models with WBC count stratified by tertiles, the mortality hazard of patients in tertile 2 was 2.38 (95% CI: 1.24-4.58, p = 0.009) and of patients in tertile 3 in the fully adjusted model was 2.64 (95% CI: 1.30-5.33, p = 0.007), compared with patients in tertile 1. Conclusion The initial WBC count may have a long-term impact on patient survival. Individuals with higher basal values or even an elevation in follow-up should therefore be strictly controlled, and all preventative measures should be made to lower the risk level.
目的 白细胞(WBC)计数因其是一种预后指标且是心血管疾病(CVD)发生的重要预测因子,在研究中被用作预测指标。关于WBC计数与腹膜透析(PD)患者全因死亡率之间关联的报道极少。考虑到PD患者中这种关联的线性关系,我们旨在探讨基线总白细胞计数是否与全因死亡率相关。
材料与方法 本研究纳入了204例新开始腹膜透析治疗的患者,这些患者于2009年1月至2017年12月期间在开塞利市医院开塞利医学院卫生科学大学肾脏病科开始治疗。研究期于2018年1月结束。使用Cox比例风险模型研究基线WBC计数与全因死亡率之间的关联。
结果 患者的平均年龄为46.75(8.49)岁,男性占48.5%。糖尿病和高血压在人群中的患病率分别为59.8%和76%。平均WBC计数为9.37(2.70)×10⁹/µL。在粗模型中,每增加一个单位,死亡风险增加23%。在完全校正模型中,死亡风险为1.12[95%置信区间(CI):1.02 - 1.23,p = 0.015]。在按三分位数分层的WBC计数模型中,与第一三分位数的患者相比,第二三分位数患者在完全调整模型中的死亡风险为2.38(95%CI:1.24 - 4.58,p = 0.009),第三三分位数患者的死亡风险为2.64(95%CI:1.30 - 5.33,p = 0.007)。
结论 初始WBC计数可能对患者生存有长期影响。因此,基础值较高或随访中出现升高的个体应受到严格控制,并应采取所有预防措施以降低风险水平。