Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Systemic Immune-Inflammation Index Association with Nutritional Markers in Maintenance Hemodialysis Patients

Toktam  Alirezaei; Farhad  Esmailsorkh; Sara  Assadiasl; Mohsen  Aghabagheri; Nooshin  Dalili; Hossein  Amini; Mahboobeh  Freidoon

doi:10.18502/jimc.v9i3.21833

Toktam Alirezaei Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Farhad Esmailsorkh Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Sara Assadiasl Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Mohsen Aghabagheri Department of Nephrology, Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Nooshin Dalili Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Hossein Amini Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mahboobeh Freidoon Department of Nephrology, Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v9i3.21833

Keywords: Hemodialysis, Neutrophil to lymphocyte ratio, Platelet to lymphocyte ratio, Systemic immune-inflammation index

Abstract

Background: Cardiovascular Disease (CVD) is the leading cause of death in patients with End-Stage Renal Disease (ESRD) undergoing Hemodialysis (HD). Recent studies have demonstrated that the Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII) may help identify individuals at high risk of CVD. Malnutrition and inflammation have also been identified as significant risk factors for CVD in HD patients.

Methods: Eighty-nine patients undergoing maintenance hemodialysis were included in the study. Nutritional parameters—including albumin, uric acid, Blood Urea Nitrogen (BUN), creatinine, triglycerides, cholesterol, Low-Density Lipoprotein (LDL), High-Density Lipo-protein (HDL), Fasting Blood Sugar (FBS), and Hemoglobin A1c (HbA1c)—were measured. The relationship between these parameters and NLR, PLR, and SII, was analyzed.

Results: BUN, creatinine, uric acid, ferritin, FBS, HbA1c, LDL, and triglycerides were positively correlated with PLR, NLR, and SII (p<0.05). Conversely, albumin was negatively correlated with NLR and SII; as albumin levels increased, NLR and SII decreased (p<0.05). The correlation between albumin and PLR was not statistically significant (p>0.05). HDL was significantly negatively associated with NLR, PLR, and SII. Additionally, age had a significant effect on the variation of SII, NLR, and PLR (p<0.05).

Conclusion: The three novel inflammatory composite indices—SII, NLR, and PLR—were closely associated with common nutritional biomarkers and may serve as cost-effective and convenient markers for predicting clinical prognosis in ESRD patients with CVD risk.