A Comparative Study on the Value of Blood Cellular Indices in Predicting the Outcomes in End Stage Renal Disease

BackgroundEnd Stage Renal Disease (ESRD) is the final stage of chronic kidney disease (CKD), where patients retain only <15% of their kidney function. Recent studies on neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) have demonstrated strong predictive utility in ESRD progression; however, there is limited research on ESRD prognosis in relation to additional blood cellular indices. In this study, 11 blood cellular indices, both well-established and lesser-known markers, were evaluated in relation to ESRD as potential prognostic tools.MethodsData was sourced from Loyola University Medical Center (LUMC) clinical database, comparing ESRD patients (n=67) with healthy, non-ESRD ambulatory patients (n=102), randomly identified in 2023. Median, interquartile ranges (IQR), p-values, and fold changes were calculated, clinical and demographic information was collected, and a Spearman correlation matrix was generated on R.ResultsThe Mann-Whitney U test revealed significant differences (p<0.05) in most indices between the two groups, except for the (PLR) with differing fold changes from the healthy ambulatory cohort. The Spearman Correlation matrix indicated weak (0.0-0.2), moderate (0.21-0.6), and strong (0.61-1.0) positive and negative correlations between previously studied indices and indices in this study.ConclusionsDespite variability within each cohort, these results highlight the potential of additional blood cellular indices to serve as prognostic markers in ESRD mortality, inflammation, and cardiovascular disease. This study provides the basis for evaluating these indices in a longitudinal manner to assess disease progression.