Mureșan Adrian Vasile, Russu Eliza, Arbănași Emil Marian, Kaller Réka, Hosu Ioan, Arbănași Eliza Mihaela, Voidăzan Septimiu Toader
Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Târgu Mureș, Romania.
Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Târgu Mureș, Romania.
Biomedicines. 2022 May 29;10(6):1272. doi: 10.3390/biomedicines10061272.
Background: Chronic kidney disease (CKD) is a global public health problem with a high mortality rate and a rapid progression to end-stage kidney disease (ESKD). Recently, the role of inflammation and the correlation between inflammatory markers and CKD progression have been studied. This study aimed to analyze the predictive value of the neutrophil−lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in assessing the outcome of ESKD patients. Methods: A retrospective study which included all patients admitted in the Department of Nephrology of the County Emergency Clinical Hospital, Târgu-Mureș, Romania, between January 2016 and December 2019, diagnosed with ESKD. Results: Mortality at 30 days was clearly higher in the case of the patients in the high-NLR groups (40.12% vs. 1.97%; p < 0.0001), high-MLR (32.35% vs. 4.81%; p < 0.0001), and respectively high-PLR (25.54% vs. 7.94%; p < 0.0001). There was also a significant increase in the number of hospital days and the average number of dialysis sessions in patients with high-NLR (p < 0.0001), high-MLR (p < 0.0001), and high-PLR (p < 0.0001). The multivariate analysis showed that a high baseline value for NLR (p < 0.0001), MLR (p < 0.0001), and PLR (p < 0.0001) was an independent predictor of 30-day mortality for all recruited patients. Conclusions: Our findings established that NLR, MLR, and PLR determined at hospital admission had a strong predictive capacity of all-cause 30-day mortality in ESKD patients who required RRT for at least 6 months. Elevated values of the ratios were also associated with longer hospital stays and more dialysis sessions per patient.
慢性肾脏病（CKD）是一个全球性的公共卫生问题，死亡率高且迅速进展为终末期肾病（ESKD）。最近，炎症的作用以及炎症标志物与CKD进展之间的相关性已得到研究。本研究旨在分析中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）和血小板与淋巴细胞比值（PLR）在评估ESKD患者预后中的预测价值。方法：一项回顾性研究，纳入2016年1月至2019年12月期间在罗马尼亚特尔古穆列什县急诊临床医院肾病科住院的所有诊断为ESKD的患者。结果：高NLR组患者30天死亡率明显更高（40.12%对1.97%；p<0.0001），高MLR组（32.35%对4.81%；p<0.0001），以及高PLR组（25.54%对7.94%；p<0.0001）。高NLR（p<0.0001）、高MLR（p<0.0001）和高PLR（p<0.0001）患者的住院天数和平均透析次数也显著增加。多因素分析显示，NLR（p<0.0001）、MLR（p<0.0001）和PLR（p<0.0001）的高基线值是所有纳入患者30天死亡率的独立预测因素。结论：我们的研究结果表明，入院时测定的NLR、MLR和PLR对至少需要6个月肾脏替代治疗（RRT）的ESKD患者的30天全因死亡率具有很强的预测能力。这些比值升高还与患者更长的住院时间和更多的透析次数相关。
