Role of neutrophil-to-lymphocyte ratio as a prognostic indicator for hemodialysis arteriovenous fistula failure

Abstract

Objective: To evaluate the role of preoperative peripheral blood neutrophil-to-lymphocyte ratio in predicting early arteriovenous fistula failure. The impact of postoperative neutrophil-to-lymphocyte ratio on arteriovenous fistula failure was also investigated. Methods: Medical records from 470 patients who underwent first-time arteriovenous fistula creation were studied. Demographic, clinical, and laboratory data were obtained. Receiver operating characteristic curves were constructed to determine the optimal cutoff values of preoperative and postoperative neutrophil-to-lymphocyte ratios for predicting early arteriovenous fistula failure. Univariate and multivariate analyses were performed to evaluate whether the neutrophil-to-lymphocyte ratio parameters were prognostic indicators for arteriovenous fistula failure. Results: Complete data from 396 patients were studied. The prevalence of early arteriovenous fistula failure was 30.6%. The optimal cutoff values of preoperative and postoperative neutrophil-to-lymphocyte ratios for predicting early arteriovenous fistula failure were 2.7 (82.6% sensitivity and 52.0% specificity) and 2.9 (78.5% sensitivity and 73.1% specificity), respectively. By univariate and multivariate analyses, high preoperative and postoperative neutrophil-to-lymphocyte ratios were significantly associated with early arteriovenous fistula failure. The adjusted odds ratios were 5.46 (95% confidence interval: 3.15–9.48) and 7.19 (95% confidence interval: 4.12–12.55), respectively. Conclusions: High preoperative and postoperative neutrophil-to-lymphocyte ratios significantly predict early arteriovenous fistula failure.

Role of neutrophil-to-lymphocyte ratio as a prognostic indicator for hemodialysis arteriovenous fistula failure. Response to Drs Akkaya and Bilen

“…I would like to thank Drs Akkaya and Bilen for their interest and thoughtful comments on my recent article involving the role of neutrophil-to-lymphocyte (NLR) ratio as a prognostic indicator for hemodialysis arteriovenous fistula (AVF) failure. 1 They mentioned a consistent finding from their study that NLR and other hematologic parameters were predictors of AVF thrombosis (failure). 2 The main purpose of my study was to evaluate the impact of patients' inflammatory status, as measured by a change in preoperative/postoperative NLR, on early AVF failure.…”

High Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Are Associated with a Higher Risk of Hemodialysis Vascular Access Failure

“…Bashar et al, proposed that patients with a higher level of NLR were more likely to have a matured AVF than patients with a lower NLR level [ 24 ]; however, a more recent experience revealed that a preoperative and postoperative NLR value > 2.5 and 2.7, respectively, were associated with an AVF failure [ 25 ]. The latter results were confirmed by another recent experience in which the NLR was advocated as a reliable biomarker for vascular access complications.…”

The clinical significance of neutrophil-lymphocyte ratio in patients treated with hemodialysis complicated with lung infection

“…[20] Moreover, NLR values are closely related to the severity of the pulmonary infection and clinical prognosis [38,39] as well as associated with erythropoietin (ESA) resistance, nutritional status and healthy prognosis, arteriovenous fistula stenosis, and renal tumor prognosis, among which the main factors can be attributed to chronic inflammation in MHD patients. [19,[40][41][42]…”