INTRODUCTION: Patients with chronic kidney disease, especially those with end-stage renal disease, have an increased risk of death. Previous studies have suggested neutrophil/lymphocyte ratio (NLR) was related to worse outcome in patients undergoing hemodialysis (HD). However, monocyte/lymphocyte ratio (MLR) has not been evaluated in HD patients. In this study, we prospectively studied the predictive value of MLR for all-cause and cardiovascular mortality in HD patients and compared it with NLR. METHODS: Patients who had been on a HD treatment for at least 6 months were enrolled. MLR was calculated by dividing the monocyte count by the lymphocyte count. Survival outcomes were estimated using the Kaplan-Meier method and compared by the log-rank test. Univariate and multivariate analyses were performed to evaluate the prognostic impact of MLR and other clinical factors on all-cause and cardiovascular mortality. RESULTS: Mortality rates for the lowest, middle, and highest MLR tertile group were 3.65, 7.02, and 11.15, respectively per 100 patient-years. The Kaplan-Meier analysis revealed that survival rates were significantly different among three MLR groups (P < 0.001). In multivariate Cox regression analyses, MLR was independently associated with all-cause mortality (HR 4.842; 95% CI, 2.091-11.214; P < 0.001) and cardiovascular mortality (HR 6.985, 95% CI 1.943-25.115, P = 0.003) as continuous variables. NLR was not an independent predictor of all-cause nor cardiovascular mortality after adjusted with MLR. CONCLUSIONS: The main finding of the study suggest that higher MLR was a strong and independent predictor of all-cause and cardiovascular mortality and overwhelmed NLR among HD patients.
INTRODUCTION:Patients with chronic kidney disease, especially those with end-stage renal disease, have an increased risk of death. Previous studies have suggested neutrophil/lymphocyte ratio (NLR) was related to worse outcome in patients undergoing hemodialysis (HD). However, monocyte/lymphocyte ratio (MLR) has not been evaluated in HDpatients. In this study, we prospectively studied the predictive value of MLR for all-cause and cardiovascular mortality in HDpatients and compared it with NLR. METHODS:Patients who had been on a HD treatment for at least 6 months were enrolled. MLR was calculated by dividing the monocyte count by the lymphocyte count. Survival outcomes were estimated using the Kaplan-Meier method and compared by the log-rank test. Univariate and multivariate analyses were performed to evaluate the prognostic impact of MLR and other clinical factors on all-cause and cardiovascular mortality. RESULTS: Mortality rates for the lowest, middle, and highest MLR tertile group were 3.65, 7.02, and 11.15, respectively per 100 patient-years. The Kaplan-Meier analysis revealed that survival rates were significantly different among three MLR groups (P < 0.001). In multivariate Cox regression analyses, MLR was independently associated with all-cause mortality (HR 4.842; 95% CI, 2.091-11.214; P < 0.001) and cardiovascular mortality (HR 6.985, 95% CI 1.943-25.115, P = 0.003) as continuous variables. NLR was not an independent predictor of all-cause nor cardiovascular mortality after adjusted with MLR. CONCLUSIONS: The main finding of the study suggest that higher MLR was a strong and independent predictor of all-cause and cardiovascular mortality and overwhelmed NLR among HDpatients.
Authors: Adrian Vasile Mureșan; Eliza Russu; Emil Marian Arbănași; Réka Kaller; Ioan Hosu; Eliza Mihaela Arbănași; Septimiu Toader Voidăzan Journal: Biomedicines Date: 2022-05-29
Authors: Serika D Naicker; Sarah Cormican; Tomás P Griffin; Silvia Maretto; William P Martin; John P Ferguson; Deirdre Cotter; Eanna P Connaughton; M Conall Dennedy; Matthew D Griffin Journal: Front Immunol Date: 2018-12-06 Impact factor: 7.561
Authors: Charlotte D C C van der Heijden; Esther M M Smeets; Erik H J G Aarntzen; Marlies P Noz; Houshang Monajemi; Simone Kersten; Charlotte Kaffa; Alexander Hoischen; Jaap Deinum; Leo A B Joosten; Mihai G Netea; Niels P Riksen Journal: J Clin Endocrinol Metab Date: 2020-05-01 Impact factor: 5.958
Authors: Konstantinos Sechidis; Konstantinos Papangelou; Paul D Metcalfe; David Svensson; James Weatherall; Gavin Brown Journal: Bioinformatics Date: 2018-10-01 Impact factor: 6.937