Shi Changjing, Wang Juan, Liu Weichen, Mo Yiyi, Huang Yuan, Wei Xiaoxiao, Huo Dongmei, Huang Aifang
Information Technology Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China.
Department of Blood Purification, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China.
Int J Gen Med. 2025 Jul 25;18:4069-4078. doi: 10.2147/IJGM.S533135. eCollection 2025.
Neutrophil percentage-to-albumin ratio (NPAR), dually reflecting inflammation and malnutrition, is related to poor prognosis closely in a range of diseases. However, prognostic value of NPAR in maintenance hemodialysis (MHD) patients remains to be confirmed. This study aimed to investigate the association between NPAR and all-cause mortality in MHD patients.
Patients undergoing maintenance hemodialysis in the blood purification department of The First Affiliated Hospital of Guangxi Medical University from January 2021 to June 2021 were prospectively studied. NPAR was calculated by dividing neutrophils percentage by Albumin. Participants were followed for 36 months, with all-cause mortality as the primary endpoint.
There were 146 male and 80 female MHD patients included in this study, with a median age of 56 years. 53 (23.5%) patients died during the follow-up period. Kaplan-Meier (K-M) analysis revealed significantly lower survival in patients with high NPAR (>16.96) compared to those with low NPAR (≤16.96) (log rank test p=0.000). Multivariate Cox regression has identified NPAR as an independent predictor of all-cause mortality (HR=1.346, 95% CI 1.192-1.521, p=0.000). Receiver operating characteristic (ROC) analysis demonstrated that the Area Under the Curve (AUC) of NPAR was 0.821 (95% CI: 0.759-0.882, p=0.000) and had a trend to be better than that of neutrophil-to-lymphocyte ratio (NLR; AUC=0.710), platelet-to-lymphocyte ratio (PLR; AUC=0.647), neutrophil count (AUC=0.606), albumin (ALB; AUC=0.752), and high-sensitivity C-reactive protein (hs-CRP; AUC=0.670).
NPAR is independently associated with all-cause mortality in MHD patients and may serve as an emerging indicator for risk stratification and prognostic management for this group of patients.
中性粒细胞与白蛋白比值（NPAR）可同时反映炎症和营养不良，在一系列疾病中与不良预后密切相关。然而，NPAR在维持性血液透析（MHD）患者中的预后价值仍有待证实。本研究旨在探讨NPAR与MHD患者全因死亡率之间的关联。
对2021年1月至2021年6月在广西医科大学第一附属医院血液净化科接受维持性血液透析的患者进行前瞻性研究。NPAR通过中性粒细胞百分比除以白蛋白计算得出。对参与者进行36个月的随访，以全因死亡率作为主要终点。
本研究纳入了146例男性和80例女性MHD患者，中位年龄为56岁。53例（23.5%）患者在随访期间死亡。Kaplan-Meier（K-M）分析显示，与低NPAR（≤16.96）患者相比，高NPAR（>16.96）患者的生存率显著降低（对数秩检验p=0.000）。多变量Cox回归确定NPAR是全因死亡率的独立预测因子（HR=1.346，95%CI 1.192-1.521，p=0.000）。受试者工作特征（ROC）分析表明，NPAR的曲线下面积（AUC）为0.821（95%CI：0.759-0.882，p=0.000），且有优于中性粒细胞与淋巴细胞比值（NLR；AUC=0.710）、血小板与淋巴细胞比值（PLR；AUC=0.647）、中性粒细胞计数（AUC=0.606）、白蛋白（ALB；AUC=0.752）和高敏C反应蛋白（hs-CRP；AUC=0.670）的趋势。
NPAR与MHD患者的全因死亡率独立相关，可能作为该组患者风险分层和预后管理的新兴指标。
