The association between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio with inflammatory factors in hemodialysis patients

Introduction: Chronic inflammation is a major factor in the pathogenesis of atherosclerosis in hemodialysis patients compared to healthy individuals. Chronic inflammation is part of the malnutrition, atherosclerosis, and inflammation syndrome in advanced renal failure. Objectives: In this study, the relationships of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) with the inflammatory factors were investigated. Patients and Methods: This cross-sectional study was conducted on 108 hemodialysis patients who were on dialysis for more than three months. For patients, serum levels of urea, creatinine (Cr), sodium, potassium, calcium, phosphate, parathyroid hormone, total cholesterol, triglyceride, ferritin, 25-hydroxy vitamin D, albumin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and complete blood cell count were assessed before dialysis since serum urea was examined again after dialysis too. Results: The mean age of the patients (58 male and 50 female) was 63.43±14.65 years. The median values for NLR and PLR were 2.25 and 114.7, respectively. ESR was significantly higher in hemodialysis patients with NLR >2.25 (46.7±29.7 versus 36±22.7) and in those with PLR >114.7 (47.09±27.8 versus 35.6±24.8). Plasma hemoglobin and serum 25-hydroxy vitamin D levels were observed to be lower (10.37±1.6 versus 11.7±1.8 and 33.1±2.5 versus 37.9±15.2) in patients with PLR >114.7. Bivariate correlation showed that PLR and NLR had positive significant correlation with ESR while PLR had a significant negative correlation with values of blood 25-hydroxy vitamin D hemoglobin and Cr. Conclusion: Due to availability and affordability of PLR and NLR, they could be used for early assessment of inflammation in end-stage renal disease (ESRD) patients. PLR may be better predictor than NLR (to detect inflammation.