The effect of neutrophil/high-density lipoprotein cholesterol ratio on survival in patients on maintenance hemodialysis

Abstract

Objectives: In this study, we aimed to investigate the effect of neutrophil/high-density lipoprotein cholesterol (HDL-C) ratio on survival in patients receiving maintenance hemodialysis treatment. Methods: The files of all patients who received maintenance hemodialysis treatment as renal replacement therapy in our hospital for more than 3 months between January 1, 2016, and January 1, 2022, were retrospectively scanned (n=241). The neutrophil/ HDL-C ratio was calculated by dividing the final absolute neutrophil count by HDL-C. Results: The study was conducted with 207 maintenance hemodialysis patients. The median age of the study group was 60 years (Q1-Q3=52–66 years). The median dialysis duration of patients was 37 months (Q1-Q3=17–45 months). It was determined that 22.7% (n=47) of the patients died during their follow-up. The median neutrophil/ HDL-C ratio was significantly higher in deceased patients than in survivors (197 vs. 123.5, p<0.001). The neutrophil/ HDL-C ratio value that best discriminated between deceased and surviving patients was found to be 146.1 with 95.7% sensitivity and 67.5% specificity (AUC=0.855, 95% CI=0.804–0.906, p<0.001). Kaplan–Meier curves revealed that the all-cause mortal- ity rate was significantly higher in the high neutrophil/ HDL-C ratio group than in the low neutrophil/ HDL-C ratio group (log-rank p<0.001). Conclusion: It was found that mortality was significantly increased in maintenance hemodialysis patients with a higher neutrophil/HDL-C ratio. In addition, the neutrophil/HDL-C ratio appears to be an independent risk factor for mortality in maintenance hemodialysis patients.