Neutrophil-lymphocyte ratio is associated with arterial stiffness in patients with peritoneal dialysis

Cai, Kedan; Luo, Qun; Zhu, Bo; Lv, Han; Wu, Dan; Dai, Zhiwei; Wang, Kaiyue

doi:10.1186/s12882-016-0394-4

Cited by 23 publications

(25 citation statements)

References 26 publications

(27 reference statements)

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“…PD patients are at 5-to 10-fold higher risk for developing CVD than the age-matched general population [4]. Among PD patients, CVD is the main complication and major cause of death, accounting for nearly 60% of all-cause deaths [1]. However, this excessive CVD mortality is unlikely to be fully accounted for by traditional Framingham risk factors (age, male sex, diabetes, hypertension, hyperlipidemia, and smoking) because advances in relevant treatment fail to improve CVD risk significantly in ESRD patients [3].…”

Section: Discussionmentioning

confidence: 99%

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Monocyte/Lymphocyte Ratio and Cardiovascular Disease Mortality in Peritoneal Dialysis Patients

Wen

Zhan

Wang

et al. 2020

Mediators of Inflammation

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Objectives. The monocyte-to-lymphocyte ratio (MLR), as a new marker of the systemic inflammatory response, is associated with cardiovascular disease (CVD) mortality in the general population and hemodialysis patients. However, the association between the MLR and CVD mortality in peritoneal dialysis (PD) has received little attention. Methods. In this multicenter retrospective cohort study, 1753 incident PD patients from November 1, 2005, to June 30, 2017, with a baseline MLR were enrolled. The primary endpoint was CVD mortality. The association of MLR with CVD mortality was assessed using a multivariable-adjusted Cox model and the Fine and Gray competing risk model. Results. Of 1753 patients, the mean age was 51.1±14.9 years, 56.9% of patients were male, and the Charlson comorbidity index was 4.29±1.75. During the follow-up period of 31.2±18.4 months, 368 patients died, of which 200 (54.3%) deaths were caused by CVD events. CVD mortality rates for the lowest, middle, and highest MLR tertiles were 70.6, 78.4, and 88.9 per 1000 patient-years, respectively (P<0.001). Kaplan-Meier analysis revealed that survival rates were significantly different among the three MLR groups (log rank=22.41, P<0.001). After adjusting for confounding factors, the highest MLR tertile was significantly associated with a hazard ratio (HR) for CVD mortality of 1.45 (95% confidence interval, 1.13-2.51, P=0.016). The Fine and Gray method analysis showed that using all-cause mortality as competing risk, the highest MLR tertile remained an independent predictor of CVD mortality (HR=1.39, 95% CI 1.10-2.47, P=0.021). Conclusions. Higher MLR levels at the commencement of PD may be independently associated with increased CVD mortality in PD patients.

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Section: Discussionmentioning

confidence: 99%

“…Cardiovascular disease (CVD) is a severe complication of peritoneal dialysis (PD) and is to blame for nearly 60% of all-cause deaths in this population [1]. The high CVD mortality is not entirely explained by traditional cardiovascular risk factors [2].…”

Section: Introductionmentioning

confidence: 99%

Monocyte/Lymphocyte Ratio and Cardiovascular Disease Mortality in Peritoneal Dialysis Patients

Wen

Zhan

Wang

et al. 2020

Mediators of Inflammation

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“…Turkmen et al [5] also found that NLR could predict vascular calcification in patients with ESRD receiving peritoneal dialysis or hemodialysis. Recently, Cai et al [1] reported that NLR was independently associated with brachial-ankle pulse wave velocity (baPWV) in patients on peritoneal dialysis. But to date, little was known of the prognostic value of NLR in patients undergoing PD.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiovascular disease is the main complication and major cause of death in patients undergoing peritoneal dialysis (PD), accounting for nearly 60% of all deaths in this population [1]. The high cardiovascular mortality associated with chronic renal disease, especially in patients with end-stage renal disease (ESRD), is not entirely explained by traditional cardiovascular risk factors [2].…”

Section: Introductionmentioning

confidence: 99%

High Neutrophil-to-Lymphocyte Ratio is a Significant Predictor of Cardiovascular and All-Cause Mortality in Patients Undergoing Peritoneal Dialysis

Wang

Zhang

et al. 2018

Kidney Blood Press Res

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Background/Aims: Chronic inflammation is associated with increased risk of cardiovascular death in patients with end-stage renal disease (ESRD). Although elevated neutrophil-tolymphocyte ratio (NLR), a novel inflammatory marker, has been shown to predict cardiovascular disease and all-cause mortality in the general population, limited evidence is available for its role in ESRD. Methods: We enrolled 86 patients undergoing peritoneal dialysis (PD) for a 36-month follow-up to investigate the association between the NLR and arterial stiffness markers, namely, carotid-femoral pulse wave velocity (cfPWV) and carotid augmentation index (AIx), and mortality in PD patients. The primary endpoints were cardiovascular mortality and all-cause mortality. Kaplan-Meier curves were used to show the cumulative incidence of cardiovascular mortality and all-cause mortality. Results: High NLR was found to be a predictor of increased cfPWV (β = 1.150; P < 0.001) and AIx (β = 3.945; P < 0.001) in patients on PD. Patients with higher NLR had lower survival during follow-up. Kaplan-Meier curves showed that the cumulative incidences of both cardiovascular mortality and all-cause mortality were significantly higher in patients with NLR ≥ 4.5 (both P < 0.01). Conclusion: Our results suggest that high NLR is independently associated with arterial stiffness and predicts cardiovascular and all-cause mortality in PD patients.

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“…Both NLR and AAC are associated with arterial stiffness, as neutrophil-to-lymphocyte ratio is independently associated with arterial stiffness in patients with advanced kidney disease, and aortic calcification is associated with arterial stiffness in the general population and hypertensive patients [28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Markers of Atherosclerosis in Hypertensive Patients with Less Advanced Chronic Kidney Disease

Suciu

Varga

Buicu

et al. 2019

Acta Medica Marisiensis

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Objective: Our study aimed to validate the neutrophil-to-lymphocyte ratio (NLR) as a marker for aortic arch calcification in hypertensive patients with less advanced chronic kidney disease (CKD).Methods: A number of forty-four hypertensive patients with chronic kidney disease (categories G3a and G3b – 2012 KDIGO nomenclature) were included in the study. Considering the presence of aortic arch calcification (AAC) on chest X-ray, the study population was divided into two groups: 27 patients AAC present and seventeen without aortic arch calcification. Laboratory data were collected for each patient and NLR was computed. Comorbidities were also recorded: stable coronary artery disease, lower extremity arterial disease and hypertensive heart disease.Results: A positive correlation between neutrophil-to-lymphocyte ratio and aortic arch calcification in hypertensive CKD patients was identified. Furthermore, advanced age, increased alkaline phosphatase and increased erythrocyte sedimentation rate had a positive association with aortic arch calcification. We found no statistical correlation between neutrophil-to-lymphocyte ratio and other laboratory features in both groups of patients.Conclusions: Neutrophil-to-lymphocyte ratio may be viewed as a potential risk factor for vascular calcification in patients with moderate chronic kidney disease; nevertheless, future extensive studies are necessary. In the management of hypertensive patients, general medicine might particularly benefit of this simple, readily available inflammatory marker.

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Neutrophil-lymphocyte ratio is associated with arterial stiffness in patients with peritoneal dialysis

Cited by 23 publications

References 26 publications

Monocyte/Lymphocyte Ratio and Cardiovascular Disease Mortality in Peritoneal Dialysis Patients

Monocyte/Lymphocyte Ratio and Cardiovascular Disease Mortality in Peritoneal Dialysis Patients

High Neutrophil-to-Lymphocyte Ratio is a Significant Predictor of Cardiovascular and All-Cause Mortality in Patients Undergoing Peritoneal Dialysis

Markers of Atherosclerosis in Hypertensive Patients with Less Advanced Chronic Kidney Disease

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