Neutrophil‑to‑lymphocyte ratio and red blood cell distribution width‑to‑platelet ratio predict cardiovascular events in hemodialysis patients

Abstract

Cardiovascular diseases are among the primary causes of decreased quality of life as well as mortality of hemodialysis patients with end-stage renal disease. The aim of the present study was to evaluate the predictive value of the red blood cell distribution width (RDW)-to-platelet ratio (RPR) and neutrophil-to-lymphocyte ratio (NLR) regarding the occurrence or development of cardiovascular events in hemodialysis patients, as well as the prognostic value of this metric. A total of 219 hemodialysis patients with cardiovascular events (HCE group) and 276 hemodialysis patients with no cardiovascular events (HNCE group) were enrolled in the present study. The clinical characteristics and laboratory parameters on admission, including RDW, as well as neutrophil, lymphocyte and platelet counts, were recorded. The NLR and RPR were increased in the HCE group compared with those in the HNCE group and there was a positive association between the NLR or RPR and the incidence of cardiovascular events in hemodialysis patients. In the receiver operating characteristics curve analysis, the area under the curve of the RPR for predicting cardiovascular events in hemodialysis patients was 0.88, while that for the NLR was 0.84. The sensitivity and specificity of the RPR for predicting cardiovascular events in hemodialysis patients were 0.87 and 0.82 respectively, and for the NLR, they were 0.75 and 0.79, respectively. The RPR was an independent risk factor for the prognosis regarding cardiovascular events in hemodialysis patients. In addition, the NLR and RPR were correlated with brain natriuretic peptide (BNP), cardiac troponin I (cTnI), creatine kinase isoenzyme-MB (CK-MB), and associated with ST segment changes in HCE patients. In conclusion, it was possible to predict the incidence of cardiovascular events in hemodialysis patients using the NLR and RPR, while the RPR had a better sensitivity and specificity than the NLR. The RPR was an independent risk factor for the prognosis regarding cardiovascular events in hemodialysis patients. These routinely available parameters should be considered as novel diagnostic markers for the occurrence and development of cardiovascular events in hemodialysis patients and their prognosis.

The Predictive Value of NLR, MLR, and PLR in the Outcome of End-Stage Kidney Disease Patients

“…The predictive role of NLR on the mortality of ESKD patients on dialysis has been demonstrated in several recently published papers [ 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. Some of these papers compared the values of NLR and PLR.…”

Pulmoner Tutulumu Olan Sistemik Skleroz Hastalarında Hematolojik Parametrelerin Rolü

“…Besides RDW, increasing number of reports emphasize the inflammatory and prognostic significance of the RPR. [28][29][30][31][32] Although the pathophysiological role of the inflammation marker RPR remains unclear, its elevation augments the probability of an increased RDW and a decreased platelet count. RPR is considered a strong predictor of the severity of fibrosis and cirrhosis in patients with chronic hepatitis and a valuable prognostic marker of inflammation in acute pancreatitis, myocardial infarction, and some malignancies.…”

Red cell distribution width-to-platelet count ratio is a promising predictor of functional bowel disease

“…RPR has been associated with various clinical conditions in medical literature. These conditions include rheumatoid arthritis, autoimmune hepatitis, cardiovascular morbidities, mortality of burned patients and acute pancreatitis [1][2][3][4][5].…”