Neutrophil to high-density lipoprotein ratio associates with higher all-cause mortality and new onset cardiovascular events in peritoneal dialysis patients

作者：Li, Mengmeng; Feng, Shaozhen; Zhan, Xiaojiang; Peng, Fenfen; Feng, Xiaoran; Zhou, Qian; Wu, Xianfeng; Wang, Xiaoyang; Su, Ning; Tang, Xingming; Wang, Zebin; Zhang, Yujing; Zeng, Yingsi; Zhu, Liya; Xie, Yuxin; Liang, Jianbo; Liu, Lingling; Wen, Yueqiang^*

来源：INTERNATIONAL UROLOGY AND NEPHROLOGY, 2022, 54(10): 2745-2754.

DOI：10.1007/s11255-022-03202-8

• Neutrophil to high-density lipoprotein ratio
• Peritoneal dialysis
• All-cause mortality
• New-onset cardiovascular events

Background Neutrophil to high-density lipoprotein ratio (NHR), a new inflammatory marker, is associated with poor clinical prognosis. However, the correlation of NHR and adverse outcomes in peritoneal dialysis (PD) patients remains unclear. Methods In this retrospective cohort study, a total of 1051 PD patients were recruited from three centers during Jan 1, 2009 to Dec 31, 2017. Eligible patients were distributed according to quartiles of the NHR. Kaplan-Meier cumulative incidence curves, multivariate COX regression, competitive risk analysis and restricted cubic spline (RCS) were applied to analyze the relationship between NHR and all-cause mortality as well as cardiovascular events (CVE). In addition, forest plots were used to calculate the interaction between different subgroups. Results During follow-up, a total of 240 all-cause mortality and 157 new-onset CVE were recorded. The all-cause mortality in the highest quartile of NHR (> 5.43) were higher than those in the other groups. RCS showed a non-linear relationship between NHR and adverse outcomes. Multivariate COX regression indicated elevated NHR was an independent risk factor for all-cause mortality. Compared to the highest quartile, hazard ratio (HR) of new-onset CVE equals to 0.522 (95% CI 0.321-0.849) in the secondary quartile (2.43 < NHR <= 3.57), and the HR of all-cause mortality analysis is 0.551 (95% CI 0.378-0.803) in the third quartile (3.57 < NHR <= 5.43). Kaplan-Meier analysis suggested there were significant differences in all-cause mortality and new-onset CVE among four NHR groups. Conclusions NHR was a new independent risk factor for all-cause mortality in PD patients.

• 单位
  广州医学院; 郑州大学; 1; 南方医科大学; 6; 南昌大学; 上海交通大学; 中山大学