Neutrophil/lymphocyte ratio associated with mortality in patients with chronic kidney disease stage 5 starting hemodialysis in a public hospital

Venegas Justiniano Y.; Samaniego Mojica W.; Hurtado Aréstegui A. · Revista Colombiana de Nefrologia (2025) · DOI: 10.22265/acnef.12.2.885

Resumen

Background: The neutrophil-lymphocyte ratio (NLI) is an easily accessible biomarker that reflects both systemic inflammation and endothelial dysfunction, and has been used in patients with cardiovascular disease, cancer, and chronic kidney disease (CKD). Purpose: To determine the association of the NLI with mortality in patients with chronic kidney disease stage 5 (CKD-5), prevalent in hemodialysis, between the years 2015-2016, in a public Hospital. Methodology: Cohort, observational and analytical design, the sampling was non-probabilistic and by convenience. We evaluated 250 records of patients with CKD-5 in ambulatory hemodialysis for at least 3 months, which started hemodialysis at the Hospital Nacional Arzobispo Loayza (HNAL) between the years 2015-2016, then were referred to external dialysis centers and had subsequent follow-up in the nephrology service of the HNAL, the observation ended on December 31, 2019. Multiple regression using generalized linear models was used in the analysis. The exposure variable was INL (≥3.5 and <3.5) and the outcome variable was vital status at the end of the observation. Results: The median age was 65 years with interquartile range (IQR) from 57 to 71, the percentage of deceased was 24 % and the median observation time was 3.8 years IQR (2.8-3.9). In multivariate analysis, patients with NLI ≥3.5 had higher mortality (RR: 2.85, 95 %CI: 2.17-8.96, p = 0.033), adjusted for sex, age, neutrophil level, lymphocytes, platelets, C-reactive protein, ferritin, platelet-lymphocyte index, and Kt/V. The increase in 0.1 units of Kt/V was associated with a 9.7 % decrease in mortality (95 %CI: 0.02-0.08) p <0. 001. Conclusions: NLI ≥ 3.5 was associated with increased mortality in patients with CKD stage 5 on chronic hemodialysis.

Instituciones: Universidad Peruana Cayetano Heredia