A RECENT study has identified the preoperative neutrophil-to-lymphocyte ratio (NLR) as a significant predictor of early mortality in older patients requiring hemodialysis. These findings could provide valuable insights for planning dialysis access and personalising care for high-risk individuals.
The study retrospectively analysed data from 448 patients aged 70 and older undergoing their first arteriovenous access surgery at three tertiary care hospitals. Patients were divided into two groups: those who died within one year of surgery (non-survival group) and those who survived beyond one year.
The multivariate analysis revealed that a higher NLR was strongly associated with a one-year mortality risk, with a hazard ratio (HR) of 1.15 (p < 0.001). Other significant predictors of one-year mortality included cancer (HR 2.50, p = 0.02) and peripheral arterial disease (HR 4.62, p < 0.001). In contrast, platelet-to-lymphocyte and monocyte-to-lymphocyte ratios did not predict early mortality, though the latter was associated with overall mortality (HR 2.74, p < 0.007).
“These findings suggest that NLR could be a useful marker for identifying high-risk patients, enabling clinicians to make more informed decisions about dialysis access planning,” the authors noted.
While the study highlights the potential of NLR as a predictive tool, the researchers emphasised the need for further investigation to validate its use in clinical practice. Such biomarkers could revolutionise patient care by optimising treatment pathways and improving outcomes in this vulnerable population.
Aleksandra Zurowska, EMJ
Reference
Kim HK et al. Neutrophil-to-lymphocyte ratio as a predictor for early mortality in older patients requiring hemodialysis; insights for hemodialysis access planning. BMC Nephrol. 2025;DOI: 10.1186/s12882-024-03924-0.
