Mayne, K. J., Lees, J. S. , Rutherford, E., Thomson, P. C., Traynor, J. P., Dey, V. , Lang, N. N. and Mark, P. B. (2023) Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: associations with mortality in a haemodialysis cohort. Clinical Kidney Journal, 16(3), pp. 512-520. (doi: 10.1093/ckj/sfac248) (PMID:36865003) (PMCID:PMC9972818)
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Abstract
Background: Lymphocyte ratios reflect inflammation and have been associated with adverse outcomes in a range of diseases. We sought to determine any association between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) and mortality in a haemodialysis cohort, including a COVID-19 infection subpopulation. Methods: A retrospective analysis was performed of adults commencing hospital haemodialysis in the West of Scotland 2010–2021. NLR and PLR were calculated from routine samples around haemodialysis initiation. Kaplan-Meier and Cox proportional hazards analyses assessed mortality associations. Results: In 1720 haemodialysis patients over a median of 21.9 (IQR 9.1–42.9) months, there were 840 all-cause deaths. NLR but not PLR was associated with all-cause mortality after multivariable adjustment [adjusted hazard ratio (aHR) for in participants with baseline NLR in quartile 4 (NLR ≥ 8.23) versus quartile 1 (NLR < 3.12) 1.63, 95% confidence interval (CI) 1.32–2.00]. The association was stronger for cardiovascular death (NLR quartile 4 versus 1 aHR 3.06, 95% CI 1.53–6.09) than for non-cardiovascular death (NLR quartile 4 versus 1 aHR 1.85, 95% CI 1.34–2.56). In the COVID-19 subpopulation, both NLR and PLR at haemodialysis initiation were associated with risk of COVID-19-related death after adjustment for age and sex (NLR: aHR 4.69, 95% CI 1.48–14.92 and PLR: aHR 3.40, 95% CI 1.02–11.36; for highest vs lowest quartiles). Conclusions: NLR is strongly associated with mortality and specifically COVID-19-related death in haemodialysis patients while the association between PLR and adverse outcomes is weaker. NLR is an inexpensive, readily available biomarker with potential utility in risk stratification of haemodialysis patients.
| Item Type: | Articles |
|---|---|
| Additional Information: | JSL is funded by a Chief Scientist Office (Scotland) Postdoctoral Lectureship Award (PCL/20/10). NNL is supported by a BHF Centre of Research Excellence Grant (RE/18/6/34217). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Mark, Professor Patrick and Dey, Dr Vishal and Lees, Jennifer and Mayne, Dr Kaitlin and Traynor, Dr Jamie and Thomson, Dr Peter and Lang, Professor Ninian and Rutherford, Dr Elaine |
| Authors: | Mayne, K. J., Lees, J. S., Rutherford, E., Thomson, P. C., Traynor, J. P., Dey, V., Lang, N. N., and Mark, P. B. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | Clinical Kidney Journal |
| Publisher: | Oxford University Press |
| ISSN: | 2048-8505 |
| ISSN (Online): | 2048-8513 |
| Published Online: | 18 November 2022 |
| Copyright Holders: | Copyright © 2022 The Authors |
| First Published: | First published in Clinical Kidney Journal 16(3): 512-520 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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