The Relationship Between NLR,PLR And Cognitive Impairment In Maintenance Peritoneal Dialysis Patients

Objective: To study the prevalence of cognitive impairment(CI)in patients with maintenance peritoneal dialysis(MPD),and to explore the correlation between Neutrophil-to-lymphocyte ratio(NLR),Platelet-to-lymphocyte ratio(PLR)and CI in MPD patients.Methods:100 patients with MPD were selected from nephrology ward or clinic of Affiliated Hospital of Youjiang Medical College for Nationalities.The Chinese version of Montreal Cognitive Assessment(Mo CA)was used to measure cognitive function.The patients with score≥26 were divided into MPD without CI group(group A),and those with score<26 were divided into MPD with CI group(group B).The general clinical data including gender,age,body mass index(BMI),years of education and dialysis age were recorded.The blood routine,hs-CRP and blood biochemical indexes of all subjects were detected.Blood biochemical indexes included total protein(TP),albumin(ALB),calcium(CA),phosphorus(P),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C)and very low density lipoprotein(VLDL-C),blood urea nitrogen(BUN),and serum creatinine(SCR).NLR,PLR and glomerular filtration rate(GFR)were calculated.The general clinical data and differences between the two groups were analyzed,and the correlation between NLR,PLR and cognitive impairment was analyzed.Results:(1)63% of the 100 MPD patients had cognitive impairment.The patients with cognitive impairment had multiple cognitive domain impairment at the same time.In addition to the orientation was not damaged,more than 4-7 cognitive domain impairment occurred at the same time,including memory impairment as high as 100%,followed by visual space and executive function impairment as high as 96.83%,followed by language function impairment as 90.48% % 。(2)Logistic regression analysis showed that high NLR were risk factors for CI in MPD patients,but PLR was not.(3)The correlation analysis showed that NLR and PLR were not correlated with gender,age,years of education,BMI,hemoglobin(Hb),P,Ca,TP,ALB,TC,TG,LDL-C and VLDL-C.However,both of NLR and PLR were positively correlated with hs-CRP and HDL-C.NLR was positively correlated with dialysis age and white blood cell count(WBC),but PLR was not correlated with dialysis age and WBC.NLR was positively correlated with BUN,SCr and negatively correlated with GFR,while PLR was not correlated with BUN,SCr and GFR.Conclusions:(1)The prevalence rate of CI in MPD patients is high.In addition to orientation,there are multiple cognitive domain impairments.The top three cognitive domain impairments are memory,visual space and executive function and language function.(2)High NLR is closely related to CI in MPD patients,but high PLR is not related to CI in MPD patients.