Association between Neutrophil to Lymphocyte Ratio and Inflammatory Markers in Hemodialysis Patients

Abstract

Background: End stage renal disease patients on regular hemodialysis patients have higher rate of mortality and morbidity compared to the general population. Objective: This study aimed to study the association between neutrophil-to-lymphocytic ratio and other inflammatory markers (IL-6, high sensitive CRP, PLR, etc) in hemodialysis patients. Patients and methods: This study was designed to assess inflammation in hemodialysis patients and study the association between high sensitive CRP (hs-CRP) and the other inflammatory markers in those patients. Initially, forty two patients with end stage renal disease (ESRD), on regular hemodialysis in dialysis unit, Internal Medicine Department, AL-Hussien Hospital, Faculty of Medicine, Al-Azhar University-Egypt. Results: We calculated the cut off point for IL-6 that best indicates the presence of inflammation in hemodialysis patients, we found that it was value more than 30 ng/l with sensitivity 96.6, specificity 69.2%, with AUC: 00.77 and P < 0.004. Moreover, we calculated the cutoff point for PLR that is consistent with presence of inflammation in hemodialysis patients, we found that it was more than 180.2 with sensitivity 82.2%, specificity 92.3% with AUC .087 and p value equals 0.0001. In addition to calculating the cut off point for NLR that best indicates the presence of inflammation, we found that it was ≥1.6 with sensitivity 93.1%, specificity 92.3%, with AUC: 0.92 and P < 0.001. Conclusion: We can assess cardiovascular condition of our hemodialysis patients along with their morbidity and mortality with measuring these inflammatory markers which are nonexpensive and has high sensitivity and specificity.