title: The effect of biocompatible peritoneal dialysis solutions on neutrophil to lymphocyte ratio.
abstract: BACKGROUND
  Long-term exposure to dialysis solutions is an important contributor to the ongoing inflammatory process in peritoneal dialysis (PD) patients. Some studies have shown amelioration of this adverse effect with biocompatible solutions. We aimed to compare the neutrophil-to-lymphocyte (N/L) ratio in PD patients using biocompatible and standard solutions and to find out the association between N/L ratio and peritonitis indices.
  
  
  METHODS
  This was a cross-sectional, multicenter study involving 120 prevalent PD patients. Seventy-one patients (59%) were using biocompatible solutions and 49 patients (41%) were using standard solutions. From blood samples, N/L ratio and platelet-to-lymphocyte ratio were calculated and mean platelet volume, erythrocyte sedimentation rate and hs-CRP values were detected. Data regarding the peritonitis rate and time to first peritonitis episode were also recorded.
  
  
  RESULTS
  Biocompatible and standard groups were similar regarding age and gender. N/L ratio and hs-CRP levels have been found significantly higher in patients using biocompatible solutions (3.75 ± 1.50 vs. 3.27 ± 1.3, p = 0.04 and 3.2 ± 2.5 vs. 1.8 ± 2.0, p < 0.01, respectively). Peritonitis rates and time to the first peritonitis episode were found similar in patients using both types of solutions (0.23 ± 0.35 vs. 0.27 ± 0.32, p = 0.36 and 32.8 ± 35.8 vs. 21.5 ± 26.9 months, p = 0.16, respectively).
  
  
  CONCLUSIONS
  N/L ratio was significantly higher in biocompatible solution users in parallel to hs-CRP levels, so biocompatible solutions seem to be related with increased inflammation in PD patients. Although we cannot make a certain explanation, we assume that there may be an association between acidity of the peritoneal content and virulence of microorganisms.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Süleyman Demirel University Medical School , Isparta , Turkey .
authors.forename: Salih
authors.initials: S
authors.lastname: İnal
authors.forename: Gülay Ulusal
authors.initials: GU
authors.lastname: Okyay
authors.forename: Memnune Sena
authors.initials: MS
authors.lastname: Ulu
authors.forename: Veysel
authors.initials: V
authors.lastname: Kıdır
authors.forename: Atila
authors.initials: A
authors.lastname: Altuntaş
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ahsen
authors.forename: Selman
authors.initials: S
authors.lastname: Ünverdi
authors.forename: Hadim
authors.initials: H
authors.lastname: Akoğlu
authors.forename: Şeref
authors.initials: Ş
authors.lastname: Yüksel
authors.forename: Murat
authors.initials: M
authors.lastname: Duranay
authors.forename: Mehmet Tuğrul
authors.initials: MT
authors.lastname: Sezer
mesh_terms: D003430:Cross-Sectional Studies; D015314:Dialysis Solutions; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000097:blood*
chemical_list: D015314:Dialysis Solutions
keywords: Biocompatible solutions; N/L ratio; inflammation; peritoneal dialysis; peritonitis rates; standard solutions