Adequacy of Hemodialysis and its relation to Neutrophil-to-Lymphocyte ratio among patients undergoing regular Hemodialysis

Authors

1 Internal Medicine, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

2 Clinical Pathology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: One of the major concerns for patients with end-stage renal disease (ESRD) who are receiving hemodialysis is the effectiveness of the dialysis treatment. Inflammation levels are elevated in patients with inadequate dialysis. Inflammation can be detected by measuring the neutrophil-to-lymphocyte ratio (NLR). Objectives: To assess the level of HD sufficiency in (ESRD) patients and how it relates to other factors that impact patient outcomes, such as (NLR), anemia, and blood pressure. Methods: This cross-sectional study included one hundred ESRD cases from the Hemodialysis Unit at Al-Hussein University Hospital in collaboration with the Allergy and Immunology Center divided into two groups according to dialysis adequacy; group I included 66 cases with Kt/V ≥1.2 (adequate dialysis dose) and group II included 34 cases with Kt/V<1.2 (inadequate dialysis dose). Results: NLR was significantly higher among ESRD patients with inadequate dialysis dose, 3.8 (2.9-4.6) compared to 2.64 (1.96-3.3) among ESRD patients with adequate dialysis dose. The ROC curve analysis showed that NLR was a diagnostic marker of inadequate dialysis at a cutoff point 3.17, exhibiting a sensitivity of 73.5% and a specificity of 71.2%. Conclusion: Neutrophil lymphocyte ratio may be a diagnostic marker for inflammation among ESRD patients on regular HD.

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