Is White Blood Cell Count Associated With Mortality in Peritoneal Dialysis Patients?: A Retrospective Single-Center Analysis

Abstract

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 3 /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.

Risk factors of different mortality periods in older patients with end-stage renal disease undergoing urgent-start peritoneal dialysis: a retrospective observational study

“…WBC count has been reported to be a significant risk predictor for adverse events in patients undergoing PD [ 29 – 31 ]. One study reported a 23% increase in the risk of death for every 10 9 /L rise in WBC count in an approximate model [ 32 ]. The same trend was observed in our model, where the risk of mortality within six months increased by 8% for every 10 9 /L increase in the baseline WBC count in older patients treated with USPD.Interestingly, from the baseline laboratory data, WBC levels were found to be essentially within the normal range.…”

“…It has been noted that WBC counts in the middle or upper third of the normal range are associated with increased mortality [ 33 ], which suggests that WBC counts in the normal range may also offer clinically meaningful information. Higher WBC counts reflect the inflammatory state of the body [ 32 ]. Older patients are weaker against infections and more susceptible to sepsis due to decreased immunity and malnutrition [ 34 ].…”

“…WBC count is also independently associated with myocardial remodeling and the development of heart failure [ 36 , 37 ], and thereby negatively affects the survival of patients. However, the fact remains that it was not clear why increased WBC counts raised mortality [ 32 ]. We also concluded that lower WBC counts were risk factors for mortality after 6 months.…”

Systemic Immune Inflammation Index as a Key Predictor of Dialysis in Pediatric Chronic Kidney Disease with the Use of Random Forest Classifier

“…Differences in the pattern of total and differential leukocyte count have been observed when comparing adult CKD patients with non-CKD counterparts and pre-dialysis with dialysis adults [12][13][14][15][16][17]. The modulating role of platelets in CKD-related inflammatory pathways has also been reviewed [18].…”