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The prognostic value of monocyte-to-lymphocyte ratio in peritoneal dialysis patients
Yan Yang1, Yuanyuan Xu1, Peiyu Lu1
1Department of Nephrology, The Third Affiliated Hospital of Soochow University, No. 185 Juqian Road, Changzhou, 213003, Jiangsu, China.
Background:
The monocyte-to-lymphocyte ratio (MLR) is considered as a new inflammation marker. This study was aimed to investigate the prognostic value of MLR for all-cause mortality and new-onset cardiovascular disease (CVD) events in peritoneal dialysis (PD) patients.
Methods:
This study enrolled patients receiving PD treatment for ≥ 3 months. Baseline characteristics were obtained within 1 week before PD catheterization. The receiver operating characteristic curve analysis was conducted to determine the optimal cut-off value of MLR. The Kaplan-Meier curve estimated the cumulative survival rate and new CVD free survival rate. Univariate and multivariate Cox regression models were preformed to investigate the association between MLR and clinical outcomes.
Results:
A total of 369 PD patients participated in this study. During a median follow-up period of 32.83 months, 65 patients (24.2%) died, and 141 patients (52.4%) occurred new-onset CVD events. The Kaplan-Meier curve revealed that survival rate in high MLR group (MLR > 0.2168) was significantly lower than in low MLR group (P = 0.008). Patients in high MLR group were more likely to experience CVD events (P = 0.002). Even after adjustment of traditional risk factors, including age, diabetes mellitus, CVD history, smoking, hyperlipidemia, high MLR remained an independent predictor of all-cause mortality [hazard ration (HR) = 2.518, 95% confidence intervals (CI) = 1.020-6.214, P = 0.045] and new-onset CVD events (HR = 1.815, 95% CI = 1.157-2.849, P = 0.010).
Conclusions:
This study suggested that high MLR was significantly and independently associated with all-cause mortality and CVD events in PD patients. The MLR is an inexpensive and straightforward indicator to reflect systemic inflammation status and help clinicians improve PD management.
Insights
The monocyte-to-lymphocyte ratio (MLR) is a novel inflammation marker. High MLR independently predicts higher mortality and cardiovascular disease (CVD) risk in peritoneal dialysis (PD) patients, aiding clinical management.
Area of Science:
- Nephrology
- Cardiology
- Inflammation Biomarkers
Background:
- The monocyte-to-lymphocyte ratio (MLR) is emerging as a significant inflammation marker.
- Peritoneal dialysis (PD) patients face increased risks of mortality and cardiovascular disease (CVD).
Purpose of the Study:
- To evaluate the prognostic significance of MLR for all-cause mortality.
- To assess the predictive value of MLR for new-onset CVD events in PD patients.
Main Methods:
- A cohort of 369 PD patients was analyzed.
- Optimal MLR cut-off was determined using ROC analysis.
- Kaplan-Meier curves and Cox regression models assessed survival and CVD event rates.
Main Results:
- High MLR (cut-off 0.2168) was linked to significantly lower survival rates (P=0.008).
- Patients with high MLR had a higher incidence of new-onset CVD events (P=0.002).
- High MLR independently predicted all-cause mortality (HR=2.518) and CVD events (HR=1.815) after risk factor adjustment.
Conclusions:
- Elevated MLR is a significant independent predictor of mortality and CVD in PD patients.
- MLR serves as a cost-effective marker for systemic inflammation, improving PD patient management.
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