Objective To investigate the predictive value of whole blood cell-derived inflammatory indicators for all-cause mortality in maintenance hemodialysis (MHD) patients. Methods A total of 335 MHD patients from January 2022 to December 2022 at Guizhou University of Traditional Chinese Medicine Second Affiliated Hospital were included. They were divided into a deceased group (n=53) and a survival group (n=282) based on follow-up outcomes. Levels of inflammatory indicators were compared between groups. Restricted cubic splines (RCS) and logistic regression analyzed associations between inflammatory indicators and mortality risk. Receiver operating characteristic (ROC) curves assessed predictive value. Results Patients in the deceased group had higher neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), neutrophil-monocyte to lymphocyte ratio (NMLR), systemic immune inflammatory index (SII), systemic inflammatory response index (SIRI), and platelet/lymphocyte ratio (PLR) than those in the survival group (Z=-5.746, -5.275, -5.784, -4.446, -6.087, -2.222; all P＜0.05). RCS showed nonlinear relationships between SIRI, NLR, MLR, NMLR, PLR, and all-cause mortality (χ²=11.480, 20.440, 17.500, 18.830, 13.540, 10.750; P =0.003, ＜0.001, ＜0.001, ＜0.001, 0.001, 0.005). After adjusting for confounders, logistic regression identified NLR (OR=2.324, 95% CI :1.461～3.698, P＜0.001), SII (OR=2.047, 95% CI :1.365～3.070, P＜0.001), SIRI (OR=1.623, 95% CI :1.080～2.437, P=0.017), and NMLR (OR=2.302, 95% CI :1.457～3.636, P＜0.001) as independent risk factors. AUCs for predicting mortality were: NLR 0.822(95% CI :0.756～0.888), NMLR 0.822(95% CI :0.756～0.888), SII 0.817(95% CI :0.750～0885), and SIRI 0.814s (95% CI :0.747～0881). Conclusion NLR, NMLR, SII, and SIRI are significantly associated with the risk of all-cause mortality in MHD patients and can effectively predict mortality risk.
YANG Bin
,
YANG Yi-Nan
,
GU Xiao-Hong
,
ZHAO Qing-Qiong
. Predictive performance of whole-blood cell-derived inflammatory markers for all-cause death in maintenance hemodialysis patients[J]. Chinese Journal of Blood Purification, 2025
, 24(09)
: 737
-741
.
DOI: 10.3969/j.issn.1671-4091.2025.09.004
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