Platelet-to-lymphocyte ratio predicts mortality better than neutrophil-to-lymphocyte ratio in hemodialysis patients.
OBJECTIVE
Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were established showing the poor prognosis in some diseases, such as cardiovascular diseases and malignancies. The risk of mortality in patients with end-stage renal disease (ESRD) was higher than normal population. In this study, we aimed to investigate the relationship between NLR, PLR, and all-cause mortality in prevalent hemodialysis (HD) patients.


METHODS
Eighty patients were enrolled in study. NLR and PLR obtained by dividing absolute neutrophil to absolute lymphocyte count and absolute platelet count to absolute lymphocyte count, respectively. The patients were followed prospectively for 24 months. The primary end point was all-cause mortality.


RESULTS
Mean levels of neutrophil, lymphocyte, and platelet were 3904 ± 1543/mm(3), 1442 ± 494/mm(3), 174 ± 56 × 10(3)/mm(3), respectively. Twenty-one patients died before the follow-up at 24 months. Median NLR and PLR were 2.52 and 130.4, respectively. All-cause mortality was higher in patients with high NLR group compared to the patients with low NLR group (18.8 vs. 7.5 %, p = 0.031) and in patients with higher PLR group compared to patients with lower PLR group (18.8 vs. 7.5 %, p = 0.022). Following adjusted Cox regression analysis, the association of mortality and high NLR was lost (p = 0.54), but the significance of the association of high PLR and mortality increased (p = 0.013).


CONCLUSIONS
Although both NLR and PLR were associated with all-cause mortality in prevalent HD patients, only PLR could independently predict all-cause mortality in these populations.
Division of Nephrology, Department of Internal Medicine, School of Medicine, Mustafa Kemal University, 31100, Antakya, Hatay, Turkey. mustafayaprakdr@yahoo.com.
Mustafa
M
Yaprak
Division of Nephrology, Department of Internal Medicine, School of Medicine, Harran University, Urfa, Turkey.
Mehmet Nuri
MN
Turan
Department of Internal Medicine, Batman Regional State Hospital, Batman, Turkey.
Ramazan
R
Dayanan
Biochemistry, Batman Regional State Hospital, Batman, Turkey.
Selçuk
S
Akın
Biochemistry, Batman Regional State Hospital, Batman, Turkey.
Elif
E
Değirmen
Division of Medical Oncology, Batman Regional State Hospital, Batman, Turkey.
Mustafa
M
Yıldırım
Division of Nephrology, Department of Internal Medicine, School of Medicine, Mustafa Kemal University, 31100, Antakya, Hatay, Turkey.
Faruk
F
Turgut
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000378:metabolism; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D016019:Survival Analysis
D015415:Biomarkers
Hemodialysis; Inflammation; Mortality; Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio