scholarly journals Study on the Clinical Implications of NLR and PLR for Diagnosing Frailty in Maintenance Hemodialysis Patients and Their Correlations with Patient Prognosis

2022 ◽  
Vol 2022 ◽  
pp. 1-7
Author(s):  
Jun Wang ◽  
Lijuan Huang ◽  
Meichang Xu ◽  
Lei Yang ◽  
Xu Deng ◽  
...  
Keyword(s):  
Survival Rate ◽  
Serum Albumin ◽  
Multivariate Regression Analysis ◽  
Diagnostic Value ◽  
Maintenance Hemodialysis ◽  
Clinical Implications ◽  
Dialysis Adequacy ◽  
Lymphocyte Ratio ◽  
Tilburg Frailty Indicator ◽  
Patient Prognosis

Objective. To explore the clinical implications of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for diagnosing frailty in patients with maintenance hemodialysis (MHD) and their correlations with patient prognosis. Methods. A total of 185 patients with MHD admitted to the hemodialysis center of our hospital were selected, 72 of whom were diagnosed with frailty according to the Chinese version of Tilburg Frailty Indicator (TFI). The relevant data were collected, and the influencing factors of frailty in MHD patients were analyzed by one-way analysis of variance (ANOVA) and multivariate logistic regression. The value of NLR and PLR in diagnosing frailty in MHD patients was observed, and patients’ all-cause mortality was compared during the 3-year follow-up. The influences of different levels of NLR and PLR on the survival of MHD patients were investigated. Results. Multivariate regression analysis identified that serum albumin, dialysis adequacy, NLR, and PLR are independent risk factors for frailty in MHD patients ( P < 0.05 ). The area under the receiver operating characteristic (ROC) curve of NLR and PLR in diagnosing frailty in MHD patients was 0.859 and 0.799, respectively. Compared with the nonfrailty group, the 3-year mortality was higher, and the 3-year survival rate assessed by survival analysis was lower in the frailty group ( P < 0.05 ). Patients with high NLR and PLR levels showed a lower 3-year survival rate. Conclusions. Dialysis adequacy, serum albumin, NLR, and PLR are independently associated with frailty in MHD patients. NLR and PLR are of a certain diagnostic value for frailty in MHD patients. MHD patients with frailty have an unfavorable prognosis, as of those with high NLR and PLR levels.

scholarly journals Circulating fatty acid profiles are associated with protein energy wasting in maintenance hemodialysis patients: a cross-sectional study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ban-Hock Khor ◽  
◽  
Sharmela Sahathevan ◽  
Ayesha Sualeheen ◽  
Mohammad Syafiq Md Ali ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Fatty Acids ◽  
Fatty Acid ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Saturated Fatty Acids ◽  
Maintenance Hemodialysis ◽  
Model Assessment ◽  
Cross Sectional ◽  
Markers Of Inflammation

AbstractThe metabolic impact of circulating fatty acids (FAs) in patients requiring hemodialysis (HD) is unknown. We investigated the associations between plasma triglyceride (TG) FAs and markers of inflammation, insulin resistance, nutritional status and body composition. Plasma TG-FAs were measured using gas chromatography in 341 patients on HD (age = 55.2 ± 14.0 years and 54.3% males). Cross-sectional associations of TG-FAs with 13 markers were examined using multivariate linear regression adjusted for potential confounders. Higher levels of TG saturated fatty acids were associated with greater body mass index (BMI, r = 0.230), waist circumference (r = 0.203), triceps skinfold (r = 0.197), fat tissue index (r = 0.150), serum insulin (r = 0.280), and homeostatic model assessment of insulin resistance (r = 0.276), but lower malnutrition inflammation score (MIS, r =  − 0.160). Greater TG monounsaturated fatty acid levels were associated with lower lean tissue index (r =  − 0.197) and serum albumin (r =  − 0.188), but higher MIS (r = 0.176). Higher levels of TG n-3 polyunsaturated fatty acids (PUFAs) were associated with lower MIS (r =  − 0.168) and interleukin-6 concentrations (r =  − 0.115). Higher levels of TG n-6 PUFAs were associated with lower BMI (r =  − 0.149) but greater serum albumin (r = 0.112). In conclusion, TG monounsaturated fatty acids were associated with poor nutritional status, while TG n-3 PUFAs were associated with good nutritional status. On the other hand, TG saturated fatty acids and TG n-6 PUFAs had both favorable and unfavorable associations with nutritional parameters.

The association between neutrophil-to-lymphocyte ratio and contrast-induced acute kidney injury in patients with carotid artery stenting

Vascular ◽  
2021 ◽  
pp. 170853812110125
Author(s):  
Altuğ Ösken ◽  
Ahmet Öz ◽  
Muhammed Keskin ◽  
Evliya Akdeniz ◽  
Hasan Şahan ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Kidney Injury ◽  
Fold Increase ◽  
Multivariate Regression Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Life Threatening ◽  
Prolonged Hospital

Objectives Contrast-induced acute kidney injury (CI-AKI) is a life-threatening complication that leads to comorbidities and prolonged hospital stay lengths in the setting of peripheral interventions. The presence of some CI-AKI risk factors has already been investigated. In this study, we evaluated the predictors of CI-AKI after carotid artery stenting. Methods A total of 389 patients with 50% to 99% carotid artery stenosis who underwent carotid artery stenting were included in this study. Patients were grouped according to CI-AKI status. Results CI-AKI developed in 26 (6.6%) patients. Age, baseline creatinine level, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were higher and estimated glomerular filtration rate, haemoglobin and lymphocyte count were lower in CI-AKI patients. In the multivariate regression analysis, the neutrophil-to-lymphocyte ratio triggered a 1.39- to 2.63-fold increase in the risk of CI-AKI onset ( p < 0.001). Conclusions The neutrophil-to-lymphocyte ratio may be a significant predictor of CI-AKI in patients with carotid artery stenting and higher neutrophil-to-lymphocyte ratio values may be independently associated with CI-AKI.

P1379PLATELET/LYMPHOCYTE RATIO AS A MARKER OF ERYTHROPOIETIN RESPONSIVENESS IN END-STAGE RENAL DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sonja Golubović ◽  
Tijana Azasevac ◽  
Siniša Živković ◽  
Bojana Ljubiäiä‡ ◽  
Violeta Knezevic ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Laboratory Data ◽  
Moderate Intensity ◽  
Maintenance Hemodialysis ◽  
Weekly Dose ◽  
Lymphocyte Ratio ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esa Therapy

Abstract Background and Aims Neutrophil/Lymphocyte Ratio (NLR) and Platelet/Lymphocyte Ratio (PLR) are closely associated with increased inflammation in end-stage renal disease, which often contributes to the severity of anemia in these patients. Erythropoiesis stimulating agents (ESA) have become a standard treatment of anemia in hemodialysis patients. Since some patients do not respond well to erythropoietin therapy (EPO) the aim of this study is to investigate if NLR and PLR as markers of increased inflammation, could be associated with resistance to EPO therapy. Method A total of 90 patients (36 females, 54 males; mean age 60,45 ±11,58) undergoing maintenance hemodialysis and who received recombinant human EPO therapy were examined. Patients' clinical characteristics, laboratory data, dialysis adequacy and the applied doses os EPO were examined in a period of 3 months. EPO hyporesponsiveness index (EHRI) was calculated as the weekly dose of EPO divided by kilograms of body weight divided by the hemoglobin level. Results Obtained results show a statistically significant correlation of moderate-intensity between EHRI and NLR ( r = 0.497, p &lt; 0.01) as well as a negative correlation of moderate-intensity between EHRI and hemoglobin levels (Hgb) (r = -0.403, p &lt; 0.01). When it comes to the connection of NLR and PLR with logarithmically converted EHRI values, the results show that there is no statistically significant correlation between NLR and EHRI. Comparison of PLR among 25th, 50th and 75th percentile of EHRI showed that PLR levels increased going from the 25th towards the 75th percentile (p &lt; 0.01). Post hoc analysis indicated that there is also a statistically strong connection for the 25th i 50th percentile (&lt;0 .05) and furthermore for the 50th and 75th percentile (&lt; 0.05). Conclusion PLR was found to be superior to NLR in terms of evaluating ESA therapy resistance. PLR could be used as a predictor of ESA therapy response.

scholarly journals Rs56288038 (C/G) in 3'UTR of IRF-1 Regulated by MiR-502-5p Promotes Gastric Cancer Development

2016 ◽  
Vol 40 (1-2) ◽  
pp. 391-399 ◽  
Author(s):  
Bo Wang ◽  
Huan Yang ◽  
Liqin Shen ◽  
Ji Wang ◽  
Wangyang Pu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Target Genes ◽  
Diagnostic Value ◽  
Tumor Promoter ◽  
Luciferase Reporter ◽  
Nucleotide Polymorphisms ◽  
Susceptible Population ◽  
Poor Differentiation ◽  
Regulatory Capacity

Background/Aims: Interferon regulatory factor 1 (IRF-1) has been shown to function as a transcriptional activator or repressor of a variety of target genes. However, its upstream, non-coding RNA-related regulatory capacity remains unknown. In this study, we focus on the miRNA-associated single nucleotide polymorphisms (SNPs) in the 3′untranslated region (UTR) of IRF-1 to further investigate the functional relationship and potential diagnostic value of the SNPs and miRNAs among Chinese gastric cancer (GC) patients. Methods: We performed a case-control study with 819 GC patients and 756 cancer-free controls. Genotyping by realtime PCR assay, cell transfection, and the dual luciferase reporter assay were used in our study, and the 5-year overall survival rate and relapse-free survival rate in different groups were investigated. Results: We found that patients suffering from Helicobacter pylori (Hp) infection were the susceptible population compared to controls. SNP rs56288038 (C/G) in IRF-1 3′UTR was involved in the occurrence of GC by acting as a tumor promoter factor. SNP rs56288038 (C/G) could be up-regulated by miR-502-5p, which caused a down-regulation of IRF-1 in cell lines and decreased apoptosis induced by IFN-γ. Carrying the G genotype was related to significantly low expression of IRF-1 and Hp infection, poor differentiation, big tumor size, invasion depth, as well as the high probability of metastasis, and moreover, the C/G SNP was associated with shorter survival of GC patients with five years of follow-up study. Conclusions: our findings have shown that the SNP rs56288038 (C/G) in IRF-1 3′UTR acted as a promotion factor in GC development through enhancing the regulatory role of miR-502-5p in IRF-1 expression.

scholarly journals Hemodialysis Experience of a Large Group of Syrian Refugees in Turkey: All Patients Deserve Effective Treatment

2019 ◽  
Vol 44 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Meltem Gursu ◽  
Mustafa Arici ◽  
Kenan Ates ◽  
Rumeyza Kazancioglu ◽  
Pinar Guneser Yavas ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Maintenance Hemodialysis ◽  
Syrian Refugees ◽  
Dialysis Adequacy ◽  
Limited Experience ◽  
Dialysis Vintage ◽  
One Year ◽  
Age Range ◽  
Annual Mortality

Background/Aims: Refugee dialysis is a worldwide growing dilemma with limited experience. This report presents the largest hemodialysis (HD) patient registry data of Syrian refugees in Turkey. Methods: Demographic, clinical, laboratory, and dialysis practice data of 345 Syrian HD patients during one year were collected and analyzed. Results: There were 345 prevalent Syrian HD patients at the end of 2016. Majority of the patients were placed in the Southeast Anatolian Region. The majority of the patients (74.8%) are in the age range of 20-64 years. Dialysis vintage in Turkey is less than 12 months in 20.8% and less than one month in 29.3% of patients. The vascular access was arteriovenous fistula in the majority of patients (72.5%). Kt/V is over 1.7 in 57%, serum albumin is above 35 g/L in 65.8% and hemoglobin level is more than 100 g/L in %65.2 of the patients. The ratio of patients with serum phosphorus level of 1.13-1.77 mmol/L was 56.2%. Twenty Syrian HD patients (14 male, 6 female) died within the year 2016 and annual mortality rate was 5.7%. Conclusion: This study with the largest number of Syrian refugees undergoing maintenance hemodialysis showed good dialysis practices, acceptable values for dialysis adequacy and biochemical parameters along with lower mortality compared to native HD population of Turkey. Longer follow up will enrich the knowledge related to care of refugee population in all over the world.

scholarly journals Pre-Dialytic SpO2 Measured with a Wearable Device as a Predictor of Mortality in Patients with OSA and Chronic Kidney Disease

2021 ◽  
Vol 11 (22) ◽  
pp. 10674
Author(s):  
Hsiao-Wei Lu ◽  
Pin-Hung Kuo ◽  
Cheuk-Sing Choy ◽  
Chih-Yu Hsieh ◽  
Jia-Feng Chang ◽  
...  
Keyword(s):  
Multivariate Regression Analysis ◽  
Wearable Device ◽  
Maintenance Hemodialysis ◽  
Mortality Risks ◽  
Hazard Ratios ◽  
Obstructive Sleep ◽  
High Prevalence ◽  
Potential Risk Factors ◽  
Threat To Life

Hypoxemia and obstructive sleep apnea (OSA) have been recognized as a threat to life. Nonetheless, information regarding the association between pre-dialytic pulse oximeter saturation (SpO2) level, OSA and mortality risks remains mysterious in patients with maintenance hemodialysis (MHD). Bioclinical characteristics and laboratory features were recorded at baseline. Pre-dialytic SpO2 was detected using a novel microchip LED oximetry, and the Epworth Sleepiness Scale (ESS) score greater than 10 indicated OSA. Non-adjusted and adjusted hazard ratios (aHRs) of all-cause and cardiovascular (CV) mortality were analyzed for pre-dialytic SpO2, OSA and potential risk factors. During 2152.8 patient-months of follow-up, SpO2 was associated with incremental risks of all-cause and CV death (HR: 0.90 (95% CI: 0.82–0.98) and 0.88 (95% CI: 0.80–0.98), respectively). The association between OSA and CV mortality was significant (HR: 3.19 (95% CI: 1.19–9.38). In the multivariate regression analysis, pre-dialytic SpO2 still had an increase in all-cause and CV death risk (HR: 0.88 (95% CI: 0.79–0.98), 0.82 (95% CI: 0.71–0.96), respectively). Considering the high prevalence of silent hypoxia in the post COVID-19 era, a lower pre-dialytic SpO2 level and severe OSA warn clinicians to assess potential CV risks. In light of clinical accessibility, the microchip LED oximetry could be developed as a wearable device within smartphone technologies and used as a routine screen tool for patient safety in the medical system.

scholarly journals Evaluation of diagnostic value of neutrophil to lymphocyte ratio in younger and older pediatrics suspect to acute appendicitis in Imam Hossein hospital

2020 ◽  
Vol 5 (2) ◽  
pp. e26-e26
Author(s):  
Azar Baradaran ◽  
Azar Naimi ◽  
Elahe Pirpiran ◽  
Masoud Akhlaghi
Keyword(s):  
Acute Appendicitis ◽  
Sensitivity And Specificity ◽  
Medical Center ◽  
Statistical Tests ◽  
The United States ◽  
Diagnostic Value ◽  
Neutrophil To Lymphocyte Ratio ◽  
Significance Level ◽  
Suspected Appendicitis ◽  
Lymphocyte Ratio

Introduction: Acute appendicitis in children is the most common acute surgical condition in children. Each year, 80000 children in the United States suffer from appendicitis. Objectives: The aim of this study was to evaluate diagnostic value of neutrophil to lymphocyte ratio (NLR) in younger and older pediatrics suspect of acute appendicitis in Imam Hossein hospital. Patients and Methods: This was a retrospective study conducted at Imam Hossein hospital from 2015-2017. The study population was all children with suspected appendicitis who refer to Imam Hossein medical center in Isfahan. The sample size was 423 people. The collected data were imported into SPSS software version 22 and analyzed with appropriate statistical tests. The significance level in the present study was less than 0.05. Results: The average age of participants was 7.2 ± 3.8 years. In both study groups, it was observed that the mean NLR in the normal and reactive follicular groups was significantly lower than the appendicitis and complication groups (P<0.05). The results of the present study showed that NLR diagnostic test can be a good predictor for the evaluation of appendicitis in both groups under 4 years and over 4 years. For more than 4 years’ group; AUC=0.74, P<0.001 and for less than 4 years’ group; AUC=0.69, P<0.001. For less than 4 years’ group, the cut-off score for appendicitis diagnosis was 2.3. In this cut-off, the sensitivity and specificity were equal to 0.65% and 0.72%. Additionally, for more than 4 years’ group, the cut-off for the diagnosis of appendix was 3.5. In this cut-off, the sensitivity and specificity were equal to 0.73% and 67%. Conclusion: This analysis demonstrates that NLR, in the context of appropriate clinical assessment of patients with a high a priori probability of appendicitis, has a greater diagnostic accuracy in supporting the diagnosis of appendicitis.

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