Neutrophil/lymphocyte ratio as a predictor of cardiovascular events in incident dialysis patients: a Japanese prospective cohort study

Abe, Tomoko; Kato, Shinichi; Tsuruta, Yoshinari; Sugiura, Sachiyo; Kuriyama, Takayuki; Kosugi, Tomoki; Tsuboi, Naotake; Matsuo, Seiichi; Maruyama, Shoichi

doi:10.1007/s10157-014-1046-2

Cited by 33 publications

(34 citation statements)

References 18 publications

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“…In a previous study, the blood sample was collected just before the first dialysis session, and the authors evaluated the relationship between blood sample data and all-cause and cardiovascular mortality [6]. Thus, we collected the blood sample using a similar method.…”

Section: Discussionmentioning

confidence: 99%

“…Herein, we focused on this new marker, which has never been evaluated in the nephrology and dialysis fields. The risks of the incidence of CVD events associated with several readily measured indicators have been evaluated, including the highly sensitive C-reactive protein level [4], increased troponin level [5], and neutrophil-lymphocyte ratio [6]. Recently, serum Mg has been reported as a predictor of all-cause and cardiovascular mortality in patients on maintenance and initial HD [7].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Predictive Value of the Serum Calcium-Magnesium Ratio for All-Cause and Cardiovascular Mortality in Incident Dialysis Patients

Sato¹,

Takeuchi²,

Matsuda³

et al. 2017

Cardiorenal Med

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Background/Aim: Cardiovascular disease is the most serious cause of death in patients on hemodialysis. Low serum magnesium (Mg) and high serum calcium (Ca) levels have been associated with poor outcome and cardiovascular mortality in patients on maintenance and initiation dialysis. As a more accurate marker is warranted, we evaluated the efficacy of a novel serum Ca-Mg marker of all-cause and cardiovascular mortality that indicates vessel calcification. Methods: We recruited 378 consecutive patients with end-stage renal disease who started dialysis between January 2009 and December 2015 at the Japanese Red Cross Ishinomaki Hospital. We collected data of patients' demographic characteristics and comorbidities from their electronic medical records. We retrospectively examined the association of the serum Ca-Mg ratio with all-cause and cardiovascular mortality using the Cox proportional hazard model, and determined the value that predicted cardiovascular death using the receiver operating characteristic (ROC) curve. Results: Overall, 253 patients with serum Mg and Ca data were analyzed. The 3-year survival rate of this group was 0.70 (95% confidence interval [CI] 0.55-0.80), and the hazard ratio for the risk of death was 3.94 (95% CI 1.37-11.31). The 3-year cardiovascular mortality rate was 0.12 (95% CI 0.05-0.23), which was significantly higher than that of the other groups. The ROC curve of cardiovascular mortality with the Ca-Mg ratio was greater than that of Mg (area under the curve 0.75 vs. 0.69, p = 0.037). Conclusion: A high Ca-Mg ratio was significantly associated with all-cause and cardiovascular mortality, and it was more accurate than serum Mg.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of the Predictive Value of the Serum Calcium-Magnesium Ratio for All-Cause and Cardiovascular Mortality in Incident Dialysis Patients

Sato¹,

Takeuchi²,

Matsuda³

et al. 2017

Cardiorenal Med

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“…In 2014, based on the NISE study, we reported that a higher NLR was associated with higher risk of CVD in 86 incident dialysis patients with a median follow-up of 38.7 months [3] . The main finding of that study was that a higher NLR was associated with increased risk for CVD-related events, both in terms of shorter duration from the start of the dialysis therapy to the first CVD event and a large number of cumulative CVD events during the follow-up time.…”

Section: Potential Role Of Nlr As An Inflammatory Biomarkermentioning

confidence: 99%

“…Since releasing our report [3] , the number of studies on NLR has been increasing in the fields of cancer, atherosclerotic disease including CVD in CKD patients. In 2004, Rifaioglu et al reported that NLR was higher in patients with Behçet disease compared with healthy subjects, and that increased NLR correlated with disease activity [45] .…”

Section: Potential Role Of Nlr As An Inflammatory Biomarkermentioning

confidence: 99%

“…The number one cause of death in patients with ESRD is cardiovascular disease (CVD) [1] , while the second cause is infection [2] . Recently, in a Japanese prospective cohort study, we reported on the association between CVD and the neutrophil/lymphocyte ratio (NLR), a new index of inflammation in incident dialysis patients [3] . According to 2013 data from the Japanese Society of Dialysis Therapy, the total annual death rate in Japanese dialysis patients was 9.8%, while CVD and infection death rates were 3.8% and 1.96%, respectively [4] .…”

Section: Introductionmentioning

confidence: 99%

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Neutrophil/lymphocyte ratio: A promising prognostic marker in patients with chronic kidney disease

Kato

Abe²,

Lindholm³

et al. 2015

Inflamm Cell Signal

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Chronic kidney disease (CKD), especially end-stage renal disease (ESRD), is associated with high morbidity and mortality due to cardiovascular disease (CVD) and infection, two common complications of ESRD that may be related, in part, to chronic inflammation and protein-energy wasting (PEW). Recently, in a Japanese prospective cohort study, we reported that there was significantly higher risk for CVD-related events in CKD patients with an increased neutrophil/lymphocyte ratio (NLR) at the start of their dialysis therapy. Because higher neutrophil count reflects inflammation and lower lymphocyte count may reflect malnutrition, NLR is hypothesized to be a more sensitive index than other existing inflammatory markers for detecting those at high risk for CVD-related events. This research highlight describes the potentials of NLR as a prognostic marker in patients with CKD. Although further studies are required to better understand its value as prognostic tool in clinical practice, current data suggest that NLR may be a useful and inexpensive marker for identifying CKD patients at high risk for CVD-related complications.

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Exploring systemic inflammation in children with chronic kidney disease: correlates of interleukin 6

Karava,

Kondou,

Dotis

et al. 2023

Pediatr Nephrol

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Neutrophil/lymphocyte ratio as a predictor of cardiovascular events in incident dialysis patients: a Japanese prospective cohort study

Abstract: A higher neutrophil/lymphocyte ratio is associated with increased risk of cardiovascular disease events and is a stronger predictor of future events.

Cited by 33 publications

References 18 publications

Evaluation of the Predictive Value of the Serum Calcium-Magnesium Ratio for All-Cause and Cardiovascular Mortality in Incident Dialysis Patients

Evaluation of the Predictive Value of the Serum Calcium-Magnesium Ratio for All-Cause and Cardiovascular Mortality in Incident Dialysis Patients

Neutrophil/lymphocyte ratio: A promising prognostic marker in patients with chronic kidney disease

Exploring systemic inflammation in children with chronic kidney disease: correlates of interleukin 6

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