Elevated neutrophil to lymphocyte ratio predicts overall and cardiovascular mortality in maintenance peritoneal dialysis patients

An, Xin; Mao, Haiping; Wei, Xin; Chen, Jiehui; Yang, Xiao; Li, Zhibin; Yu, Xueqing; Z, Li

doi:10.1007/s11255-012-0130-3

Cited by 62 publications

(49 citation statements)

References 22 publications

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“…Apart from vascular calcification, previous studies suggested that inflammation indicated by a higher level of CRP or the counts of white blood cells might be associated with elevated ALP and then participate in higher mortality (3,20,21). N/L is widely used as a marker of inflammation and a strong predictor for overall and cardiovascular mortality in PD patients (22). Our results also showed a positive correction between ALP and CRP as well as the N/L level ( Table 2).…”

Section: Discussionsupporting

confidence: 70%

Alkaline Phosphatase and Mortality in Patients on Peritoneal Dialysis

Liu

Guo

Feng

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Elevated total serum alkaline phosphatase levels have been associated with higher mortality in the general population, CKD patients, and hemodialysis patients. However, in peritoneal dialysis patients, this association has received little attention. The aim of this study was to evaluate the association between alkaline phosphatase and all-cause and cardiovascular mortality in peritoneal dialysis patients.Design, setting, participants, & measurements In this single center retrospective cohort study, 1021 incident peritoneal dialysis patients from January 1, 2006, to December 31, 2010 with baseline serum alkaline phosphatase values were enrolled. Collected baseline data included demographic characteristics and clinical and laboratory measurements. All patients were followed until December 31, 2012. The associations of total serum alkaline phosphatase levels with allcause and cardiovascular mortality were assessed using multivariable-adjusted Cox models.Results Of 1021 patients, mean age was 47.5 (615.5) years, 59.1% of patients were men, and 22.8% of patients were diabetic. The median serum alkaline phosphatase level was 64 U/L (interquartile range=52-82 U/L). During a median 31-month (interquartile range=19-45 months) follow-up period, 203 patients died, of which 109 deaths were caused by cardiovascular disease. After adjusting for demographics, comorbid conditions, liver function, and bone metabolism parameters, the highest alkaline phosphatase quartile was significantly associated with a hazard ratio for all-cause mortality of 1.70 (95% confidence interval, 1.06 to 2.74, P=0.03) and a hazard ratio for cardiovascular mortality of 1.94 (95% confidence interval, 1.02 to 3.72, P=0.04). Each 10 U/L higher baseline alkaline phosphatase level was associated with 4% (95% confidence interval, 1.00 to 1.08, P=0.04) and 7% (95% confidence interval, 1.02 to 1.11, P=0.003) higher risk of all-cause and cardiovascular mortality, respectively. ConclusionHigher total serum alkaline phosphatase levels at the commencement of peritoneal dialysis were independently associated with all-cause and cardiovascular mortality in peritoneal dialysis patients.

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Section: Discussionsupporting

confidence: 70%

Alkaline Phosphatase and Mortality in Patients on Peritoneal Dialysis

Liu

Guo

Feng

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…An et al found that the NLR was an independent predictor of all causes of mortality as well as cardiovascular mortality in peritoneal dialysis patients, and patients with a higher NLR showed significantly increased overall and cardiovascular mortality rates compared to patients with lower NLR. 15 We found a significant correlation between the RV/LV short-axis ratio and NLR in our study.…”

Section: Discussionsupporting

confidence: 65%

Correlation of Computerized Tomography Angiographic Pulmonary Artery Obstruction Score with Hematologic Outcome and Mortality in Patients with Acute Pulmonary Embolism

Yesildag¹,

Keskin²,

Güler³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study was to determine the relationship between the computed tomography obstruction score and radiological parameters, biochemical parameters, and mortality. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : During an 8-month period (January 2011-August 2011), 326 patients with clinically suspected pulmonary embolism (PE) were examined by computerized tomography pulmonary angiography (CTPA). Of these patients, only 95 (49 men and 46 women) were diagnosed with PE. Computerized tomography images were retrieved from the picture archiving and communication system (PACS) for the determination of right ventricle/left ventricle (RV/LV) shortaxis ratio, maximum diameter of the pulmonary artery, and vascular obstruction score according to Qanadli method. We investigated the correlation between continuous values of the Qanadli scoring system and mortality, and determined whether there was a significant difference between mortality and CTPA parameters. The values derived from the morphologic changes in the CTPA, hematological findings and gender where then assessed with respect to their impacts on mortality. R Re es su ul lt ts s: : There was a significant correlation between the PE obstruction score and RV/LV short-axis ratio (r=0.58, p<0.001), RV/LV short-axis ratio, and neutrophil to lymphocyte ratio (NLR) (r=0.21, p=0.035). Survivors and non-survivors had a statistically significant difference in the NLR and midplatelet volume (MPV) (p<0.05). The mortality incidence in patients with an increased MPV (odds ratio 1.689; 95% confidence interval (CI) 1.06-2.67; p=0.025) and older female patients (odds ratio 3.732; 95% CI 1.02-13.65; p=0.04) was higher. C Co on nc cl lu us si io on n: : Our results suggest that in patients with acute PE, NLR and MPV may be of value for the estimation of mortality.K Ke ey y W Wo or rd ds s: : Pulmonary embolism; multidetector computed tomography Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, bilgisayarlı tomografi obstrüksiyon skoru ile radyolojik, biyokimyasal parametreler ve mortalite arasındaki ilişkiyi belirlemektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Sekiz aylık periyotta (Ocak 2011-Ağustos 2011), klinik olarak pulmoner emboli kuşkulu 326 hasta bilgisayarlı tomografi pulmoner anjiyografi (BTPA) ile incelendi. Bunların sadece 95'i (49 erkek, 46 kadın) pulmoner emboli tanısı aldı. Bilgisayarlı tomografi imajları sağ ventrikül/sol ventrikül kısa aks oranlarını, pulmoner arter maksimum çapını ve Qanadli obstrüksiyon skorunu saptamak için gö-rüntü saklama ve iletişim sisteminden çağrıldı. Qanadli obstrüksiyon skoru ile mortalite arasındaki ilişki incelendi. Mortalite ve bilgisayarlı tomografi pulmoner anjiyografi parametreleri arasında anlamlı farklılık olup olmadığı araştırıldı. Bilgisayarlı tomografi pulmoner anjiyografideki morfolojik değişikliklerden elde edilen değerler, hematolojik bulgular, cinsiyet ve bunların mortalite üzerin-deki etkileri değerlendirildi. B Bu ul lg gu ul la ar r...

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“…23 One previous study reported that NLR43.5 was associated with an increase in the risk of cardiovascular and all-cause mortality in peritoneal dialysis patents. 13 Two studies have subsequently reported NLR 43.76 and 3.72 to be significant and independent (of CRP) predictors of cardiovascular events in pre-dialysis and dialysis-dependent patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Despite this, few studies have investigated the prognostic value of NLR in patients with chronic kidney disease, with none focusing solely on hemodialysis patients. 12,13 The aims of this study were to explore the relationship between NLR and other biochemical parameters, and to examine the value of NLR as a predictor of cardiovascular and all-cause mortality in hemodialysis patients.…”

Section: Introductionmentioning

confidence: 99%

Neutrophil–lymphocyte ratio predicts cardiovascular and all-cause mortality in hemodialysis patients

et al. 2015

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Neutrophil-lymphocyte ratio (NLR) is a marker of systemic inflammation that has been shown to predict mortality in patients with malignancies, ischemic heart disease and peripheral vascular disease. Its prognostic value in hemodialysis patients is unclear. The aims of this study were to: (i) explore the relationship between NLR and other biochemical parameters and (ii) to examine the value of NLR as a predictor of cardiovascular and all-cause mortality in hemodialysis patients. The study included all the incident hemodialysis patients from a single center between 2007 and 2012. NLR was calculated using samples obtained 3 months after commencing hemodialysis. One hundred seventy hemodialysis patients were included with a median follow-up of 37 months. There were 54 deaths (32%). NLR was positively correlated with C-reactive protein (r ¼ 0.24, p ¼ 0.0023) and negatively correlated with hemoglobin (r ¼ À0.27, p ¼ 0.00048), albumin (r ¼ À0.23, p ¼ 0.0034) and total cholesterol (r ¼ À0.17, p ¼ 0.049) levels. In multivariate Cox regression, NLR was independently associated with both all-cause mortality (adjusted hazard ratio [HR] 1.4; 95% confidence interval [CI], 1.2-1.6; p 0.0001) and cardiovascular death (HR 1.3, 95% CI 1.1-1.6, p ¼ 0.0032). Other predictors of all-cause mortality were age (HR 1.6 per decade; 95% CI, 1.2-2.1; p ¼ 0.0017), body mass index (HR 0.93; 95% CI, 0.88-0.98; p ¼ 0.0047), albumin (HR 0.91; 95% CI, 0.86-0.97; p ¼ 0.0035) and peripheral vascular disease (HR 2.7; 95% CI, 1.4-5.1; p ¼ 0.0023). NLR is a practical, cost-efficient and easy to use predictor of cardiovascular and all-cause mortality in incident hemodialysis patients.

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Elevated neutrophil to lymphocyte ratio predicts overall and cardiovascular mortality in maintenance peritoneal dialysis patients

Abstract: Neutrophil to lymphocyte ratio is a strong predictor for overall and cardiovascular mortality in PD patients.

Cited by 62 publications

References 22 publications

Alkaline Phosphatase and Mortality in Patients on Peritoneal Dialysis

Alkaline Phosphatase and Mortality in Patients on Peritoneal Dialysis

Correlation of Computerized Tomography Angiographic Pulmonary Artery Obstruction Score with Hematologic Outcome and Mortality in Patients with Acute Pulmonary Embolism

Neutrophil–lymphocyte ratio predicts cardiovascular and all-cause mortality in hemodialysis patients

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