Elevated white cell count at commencement of peritoneal dialysis predicts overall and cardiac mortality

Johnson, David W.; Wiggins, Kathryn J.; Armstrong, Kirsty; Campbell, Scott; Isbel, Nicole M.; Hawley, Carmel M.

doi:10.1111/j.1523-1755.2005.67135.x

Cited by 39 publications

(27 citation statements)

References 39 publications

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“…Increased white blood cells and its neutrophil component were evidenced as significant predictors of overall and CVDassociated mortality in PD patients. 13 In a large cohort including HD patients, increased neutrophil count and decreased lymphocyte count have been reported to be useful parameters of poor outcome.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil to Lymphocyte Ratio in Evaluation of Inflammation in Patients with Chronic Kidney Disease

et al. 2012

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Aim: The current data have proven the pivotal role of inflammation in the development of atherosclerosis and cardiovascular diseases in patients with chronic kidney disease (CKD). Neutrophil to lymphocyte (N/L) ratio has increasingly been reported as a measure of systemic inflammation. This study assessed N/L ratio and investigated its associations with standard inflammatory biomarkers in different stages of CKD patients. Material and methods: This cross-sectional study included 30 predialysis, 40 hemodialysis, 35 peritoneal dialysis patients, and 30 healthy subjects. N/L ratio and important clinical and laboratory parameters were registered. Multivariate regression analyses were carried out to investigate the relations of N/L ratio. Results: N/L ratio was significantly higher in each patient group compared to the healthy subjects (for all, p < 0.001). It was positively correlated with interleukin-6 (IL-6) (r ¼ 0.393, p < 0.001) and high-sensitivity C-reactive protein (hs-CRP) (r ¼ 0.264, p ¼ 0.002) levels and negatively correlated with hemoglobin (r ¼ À0.271, p ¼ 0.001), serum albumin (r ¼ À0.400, p < 0.001), and high-density lipoprotein (HDL) cholesterol levels (r ¼ À0.302, p < 0.001). In CKD patients with hypertension (HT), higher N/L ratio was detected when compared to those without HT (p ¼ 0.006). Having CKD, the presence of HT, serum albumin, HDL-cholesterol, IL-6, and hs-CRP levels were found to be independent predictors of the ratio after adjusting for significant covariates (p < 0.001). Conclusion: An easy and inexpensive laboratory measure of N/L ratio might provide significant information regarding inflammation in CKD including predialysis and dialysis patients.

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Section: Discussionmentioning

confidence: 99%

Neutrophil to Lymphocyte Ratio in Evaluation of Inflammation in Patients with Chronic Kidney Disease

et al. 2012

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“…Such biomarkers of PEW have been shown to be robust predictors of morbidity and mortality in dialysis patients (6)(7)(8)(9)(10)(11)(12)(13). These biomarkers, however, have not been subjected to similar research scrutiny in patients with NDD-CKD.…”

Section: Introductionmentioning

confidence: 99%

Outcome predictability of biomarkers of protein-energy wasting and inflammation in moderate and advanced chronic kidney disease

Kövesdy

George

Anderson

et al. 2009

The American Journal of Clinical Nutrition

143

109

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Background: Markers of protein-energy wasting (PEW) and inflammation are common in chronic kidney disease (CKD) and are among the strongest predictors of mortality in dialysis patients. Objective: We hypothesized that markers of PEW and inflammation show similar associations in patients with non-dialysis-dependent CKD (NDD-CKD). Design: We examined the associations of serum albumin, white blood cell (WBC) count, percentage of lymphocytes in WBCs (%LYM), and a combination of all 3 with all-cause mortality and with the composite of predialysis mortality or end-stage renal disease (ESRD) by using fixed-covariate and time-dependent Cox models in 1220 men with NDD-CKD. Results: Lower albumin and %LYM and a higher WBC count were significantly associated with outcomes. In time-dependent Cox models, compared with patients in whom none of these markers indicated PEW, those in whom 1, 2, or all 3 markers indicated the presence of PEW had multivariable-adjusted hazard ratios (95% CI) for all-cause mortality of 1.7 (1.2, 2.4), 2.4 (1.7, 3.4), and 3.6 (2.5, 5.1); the P for trend was ,0.001. Similar associations were present in fixed-covariate models for all-cause mortality and in fixed-covariate and time-dependent models for the composite outcome. Conclusions: Traditional and nontraditional markers of PEW display robust, strong, and independent associations with mortality in patients with NDD-CKD. Clinical trials are warranted to examine whether PEW-improving interventions can lead to better outcomes in these patients.

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“…Total peripheral blood lymphocyte count is reduced in ESRD patients undergoing hemodialysis, a finding that has been well documented since the 1980s (Manal and Shaimaa, 2015;Kuwae et al, 2005) on the other hand, neutrophile count is high in the peripheral blood of ESRD due to inflammatory processes (Turkmen et al, 2012). Cellular immunity level reflected as total lymphocyte count are reduced in ESRD patient (Johnson et al, 2005;Sakato et al, 2015), a fact that explains the frequent occurrence of infection which is the second leading cause of death in end stage renal disease patients (Egbi et al, 2014;Block et al, 2004). As it has been demonstrated, this reduction is more intense in ESRD patients undergoing maintenance hemodialysis (Block et al, 2004).…”

Section: Introductionmentioning

confidence: 69%

“…Inflammation contributes to the development of ESRD by triggering both the release of cytokines and the increased production and activity of adhesion molecules (Memoli et al, 2000;Panichi et al, 1998), which together result in lymphocyte adhesion and movement into the interstitium (Johnson et al, 2005;Roberto et al, 2003). In ESRD, the vascular endothelium is injured by numerous potential insults, including hemodynamic forces (Hatice et al, 2012;Sakato et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Correlation of lymphocyte count with serum calcium level and neutrophil-to-lymphocyte ratio in end stage renal disease patients undergoing hemodialysis in Adamawa State, Nigeria

Etim¹,

Emokpae²,

Medugu³

et al. 2017

Int. J. Med. Med. Sci.

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Low lymphocyte count in end stage renal disease (ESRD) patients receiving maintenance hemodialysis was documented. This study aims to correlate the levels of lymphocyte count with serum calcium level, and neutrophil-to-lymphocyte ratio (NLR) in ESRD patient receiving hemodialysis in Northeast Nigeria. Seventy eight (78) patients receiving hemodialysis and 75 clinically healthy subjects (control) participated in the present study. Full blood count and serum calcium level were determined by using a Sysmex XP-300 Hematology Analyzer and a Selectra Pro-S Chemistry Analyzer, respectively. The mean levels of lymphocyte count, packed cell volume, hemoglobin and serum calcium level were significantly lower (p<0.001), while neutrophil, and NLR values were significantly higher (p<0.001) in ESRD patients undergoing hemodialysis as compared to the healthy control subjects. Lymphocyte count was negatively correlated with NLR value (r=-0.341; 0.05) but positively with serum calcium (r=0.904; p<0.001). In end stage renal disease (ESRD) patient receiving hemodialysis, lymphocyte count was negatively correlated with NLR value and positively with serum calcium level.

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Elevated white cell count at commencement of peritoneal dialysis predicts overall and cardiac mortality

Cited by 39 publications

References 39 publications

Neutrophil to Lymphocyte Ratio in Evaluation of Inflammation in Patients with Chronic Kidney Disease

Neutrophil to Lymphocyte Ratio in Evaluation of Inflammation in Patients with Chronic Kidney Disease

Outcome predictability of biomarkers of protein-energy wasting and inflammation in moderate and advanced chronic kidney disease

Correlation of lymphocyte count with serum calcium level and neutrophil-to-lymphocyte ratio in end stage renal disease patients undergoing hemodialysis in Adamawa State, Nigeria

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