Correlation Between The Blood Cell Parameters And The Prognosis Of Patients With Maintenance Of Hemodialysis

1.ObjectiveTo explore the correlation between the change of blood cell parameters such as red blood cell distribution width(red blood cell distribution width RDW),neutrophil/lymphocyte ratio(neutrophils to lymphocytes thewire NLR)and the prognosis of patients with chronic renal failure maintenance of hemodialysis.2.MethodsThe clinical data of patients with end-stage renal disease(ESRD)who underwent regular dialysis for more than 3 months in the hemodialysis center of the first affiliated hospital of bengbu medical college from January 1,2017 to December 31,2018 were retrospectively analyzed.Into group RDW values as baseline to compare time average RDW,change into higher RDW group with RDW decline,general situation and the analysis of 2 groups of patients RDW hematology indexes such as the difference between,with adverse events are grouped,divided into adverse events and no event live group,analysis of two groups patients RDW,NLR indicators such as the difference between the use of Kaplan Meier and COX regression model analysis the RDW,NLR can independently predicted the prognosis of patients with MHD Spearman correlation analysis method is used to analyze the RDW.The correlation factors of NLR were analyzed and the ability of potential indicators to evaluate the long-term prognosis of patients was evaluated using the ROC curve.The optimal diagnostic point was determined by the jorden index(sensitivity + specificity-1).3.ResultsA total of 221 MHD patients,aged(56.3±13.1)years old and 31.0(8.0,58.9)months of dialysis age,were included in the study.During a median follow-up of 17.9months(1-24 months),29 deaths and 39 non-fatal adverse events occurred.The mean RDW,NLR and CRP in the adverse event group were higher than those in thenon-event survival group(Z values were 2.642,5.044 and 2.176,respectively,and P values were 0.009,<0.001 and 0.030,respectively).RDW and NLR were positively correlated with CRP(r values were 0.135 and 0.203,p values were 0.045 and 0.002,respectively).COX regression analysis showed that mean time RDW(HR = 1.300,95%CI: 1.000-1.691,P=0.049)and NLR(HR = 1.189,95%CI: 1.074-1.316,P= 0.001)were independent risk factors for adverse events in MHD patients.The areas under the ROC curve of RDW and NLR respectively were 0.608(95%CI: 0.527-0.629,P=0.010)and 0.713(95%CI: 0.636-0.790,P<0.001).4.Conclusion1)RDW NLR can be used as an indicator to reflect the inflammatory status of MHD patients and is positively correlated with CRP.2)High time mean RDW and NLR independently predicted the risk of adverse events in MHD patients.3)NLR is better than RDW in predicting the prognosis of MHD patients.