Abstract：【Objective】To explore the prognostic evaluation of microinflammatory markers combined with the neutrophil to lymphocyte ratio (NLR) in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis (MHD).【Methods】A total of 76 ESRD patients undergoing MHD were followed up for one year, and their prognosis was recorded. Based on the outcomes, patients were divided into the poor prognosis group (Group A, 18 cases) and the good prognosis group (Group B, 58 cases). Factors influencing prognosis and the efficacy of microinflammatory markers combined with NLR in prognostic assessment were analyzed.【Results】Among the 76 patients, the incidence of poor prognosis was 23.68%(18/76). Group A had higher proportions of malnutrition and infection, longer dialysis duration, and significantly elevated levels of high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and NLR compared to Group B (P<0.05). Additionally, the residual renal filtration rate in Group A was significantly lower than that in Group B (P<0.05). Independent prognostic factors for ESRD patients included residual renal filtration rate, hs-CRP, and NLR (all P<0.05). The sensitivity of hs-CRP, NLR, and their combination in predicting the prognosis of ESRD patients undergoing MHD was 72.22%, 83.33%, and 66.67%, respectively, while the specificity was 72.41%, 65.52%, and 98.28%, respectively. The specificity of the combined diagnosis of both hs-CRP and NLR was significantly higher than that of single marker's diagnosis (P<0.05).【Conclusion】The hs-CRP and NLR have good predictive value for the prognosis of ESRD patients undergoing MHD.
[1] SAGLIMBENE V M, WONG G, RUOSPO M, et al. Fruit and vegetable intake and mortality in adults undergoing maintenance hemodialysis[J].Clin J Am Soc Nephrol,2019,14(2):250-260. [2] 林晶晶, 陈少华, 姚曦, 等. 维持性血液透析患者早期死亡率及相关危险因素分析[J].中华肾脏病杂志, 2020, 36(8):595-600. [3] DEMIRCI B G, TUTAL E, EMINSOY I O, et al. Dietary fiber intake: its relation with glycation end products and arterial stiffness in end-stage renal disease patients[J].J Ren Nutr,2019,29(2):136-142. [4] BALBOUL Y, GURSHUMOV A, AZAR A, et al. Biological basis of lymphocyte ratios for survival prediction in hemodialysis patients: a longitudinal study[J].Int Urol Nephrol,2020,52(7):1345-1356. [5] 巴元明, 王小琴. 慢性肾衰竭[M]. 北京:中国医药科技出版社, 2010: 218-230. [6] FLEISHMAN T T, DREIHER J, SHVARTZMAN P. Patient-reported outcomes in maintenance hemodialysis: a cross-sectional, multicenter study[J].Qual Life Res,2020,29(9):2345-2354. [7] 高翔, 苏华俊, 邓流飞,等. 血压变异性、氨基末端脑利钠肽前体与维持性血液透析患者心血管事件的相关性分析[J].临床肾脏病杂志, 2019, 19(1):55-59. [8] 沈燕. 贵阳市某医院血液透析患者蛋白能量消耗现患调查及预后分析[D]. 重庆:第三军医大学, 2016. [9] WANG H F, LIU J, XIE D M, et al. Elevated serum uric acid and risk of cardiovascular or all-cause mortality in maintenance hemodialysis patients: A meta-analysis[J].Nutr Metab Cardiovasc Dis,2021,31(2):372-381. [10] BOURBONNAIS F F, TOUSIGNANT K F. Experiences of nephrology nurses in assessing and managing pain in patients receiving maintenance hemodialysis[J].Nephrol Nurs J,2020,47(1):37-44. [11] ZHANG A H, GUO W K, YU L, et al. Relationship of serum soluble klotho levels and echocardiographic parameters in patients on maintenance hemodialysis[J].Kidney Blood Press Res, 2019,44(3):396-404. [12] 王云丹, 蒋卫杰. hs-CRP、NLR、PLR与维持性血液透析患者心脏瓣膜钙化的相关性[J].临床肾脏病杂志, 2020, 20(2):23-27. [13] GUO M, CAO X S, SHEN B, et al. The predictive value of NT-Pro-Brain natriuretic peptide for risk of pneumonia in patients on maintenance hemodialysis[J].Blood Purif,2020,49(3):348.
2025, Vol. 42 
