Impact of Neutrophil Lymphocyte and Monocyte Lymphocyte Ratio on Chronic Kidney Disease Patients Outcome

Chronic kidney disease (CKD) is a global public health problem. With the decline in renal function, patients with end-stage kidney disease (ESKD) can choose hemodialysis (HD), peritoneal dialysis (PD) or kidney transplantation as renal replacement therapy to improve their quality of life. Globally, HD is still the most important renal replacement therapy.

With the continuous development and optimization of dialysis technology, the survival time of maintenance hemodialysis (MHD) patients is gradually prolonged. However, even in developed countries, the mortality rate of MHD patients remains high. According to data from the United States Renal Data System (USRDS) in 2019, the MHD mortality rate in 2017 was 167 per 1,000 patient-years.

Studies have shown that 30-50% of MHD patients have chronic inflammation state. Persistent inflammation can lead to a variety of complications, especially cardiovascular disease, malnutrition and anemia, thereby increasing the mortality of MHD patients.

Although less than 5% of MHD patients die directly from inflammation, inflammation can interact with a variety of risk factors and has an important impact on the prognosis of MHD patients. Studies have found that inflammation is closely related to high-risk factors of death such as myocardial hypertrophy, ventricular dysfunction, atherosclerosis, protein energy consumption, anemia and renal bone disease .

Therefore, the development of inflammation-related indicators has important clinical value for judging the prognosis of MHD patients and guiding early intervention.