Relationship between neutrophil to lymphocyte ratio and mortality and morbidity of dialysis patients in Birjand, a one-year old follow-up: brief report

Background: Chronic kidney disease is considered as one of the most common health problems in the world. High mortality and morbidity in these patients, are due to cardiovascular disease and infections. Neutrophil to lymphocyte ratio is recently known as an inflammatory marker. This study aimed to determine the ratio of neutrophil to lymphocyte count in hemodialysis patients in Birjand Special Disease Center, and its role in mortality and morbidity during one-year follow-up. Methods: This is an analytical descriptive study that was performed on 59 End-Stage Renal disease patients referred to the dialysis department of Special Disease Center, Birjand University of Medical Sciences Birjand, Iran. The levels of neutrophil to lymphocyte ratio, erythrocyte sedimentation rate, and C reactive protein were measured and cases divided into 4 groups according to the NLR: less than 1, 1-1.5, 1.5-2.5, 2.5-3.5, and>3.5. All patients were followed up for one year to determine rate of mortality, cardiovascular and infectious events. Results: The mean NLR was 2.89±1.38. There was no significant difference in mortality rate between groups according to NLR with P=0.052, also no remarkable difference in infectious and cardiovascular morbidity events in groups with P=0.09 and P=0.21, respectively. The mean NLR in patients with cardiovascular or infectious events was 4.2 and 3.75 respectively, which were notably higher than patients without cardiovascular (NLR:2.49) and infectious (NLR:2.68) events, P=0.02 and P=0.03 respectively. In the bivariate correlation analysis, NLR was positively correlated with CRP in hemodialysis patients. Conclusion: ESRD patients with NLR>2.5 have higher cardiovascular and infectious events than patients with NLR<2.5 but there was no difference in mortality rate between them.