Neutrophil/Lymphocyte Ratio Is Associated With Left Ventricular Hypertrophy In Patients With Maintenance Hemodialysis

Objective:To explore the potential relationship between NLR and LVH in patients with MHD,and its predictive value for LVH in patients with MHD,provide a theoretical basis for early detection of LVH and further intervention.Methods:Retrospective analysis of 217 patients who underwent MHD in the Department of Nephrology and Blood Purification in our hospital from January 2014 to September 2018.General data were collected(gender,age,dialysis age,primary disease,height,weight,blood pressure before dialysis),laboratory examination before dialysis(WBC?NEU?LYM?Hb?Alb?Urea?Cr?UA?Ca?P?TC?TG?HDL-C?LDL-C?hsCRP?iPTH)and echocardiography(LVEDD,LVPWT,IVST,LVEF)results.Patients were divided into low NLR group(NLR?3.67)and high NLR group(NLR > 3.67)according to the median NLR(3.67).The indicators between the two groups were compared.Pearson/Spearman correlation analysis was used to analyze LVMI and other indicators.Relevance Logistic regression was used to analyze the risk factors of LVH.The sensitivity and specificity of NLR to evaluate LVH were analysis by ROC curve.Results:(1)In the high NLR group,NEU?Urea?UA?P?hsCRP?IVST?LVPWT?LVM?LVMI and the prevalence of LVH were higher than those of the low NLR group(P <0.05),while LYM?Hb?TC?TG and LDL-C were lower than those in the low NLR group(P < 0.05).(2)NLR,P,hsCRP,SBP and PP(r=0.41,P<0.05;r=0.19,P<0.01;r=0.24,P<0.001;r=0.14,P<0.05;r= 0.2,P<0.05)showed positive correlations with LVMI,Hb showed a negative correlation with LVMI(r=-0.21,P<0.01).In multivariate analysis,NLR independently correlated with LVH in patients with maintenance hemodialysis(?=0.740,OR=2.097,95%CI1.569-2.803,P<0.001),even after adjustment for various confounders.(3)The area under the ROC curve of NLR was 0.811(95% CI 0.755-0.868,P < 0.001),a sensitivity was 62.2% and a specificity was 93.2% of NLR to evaluate LVH.Conclusion:The NLR of patients with MHD is closely related to LVMI.Regular monitoring of NLR in the clinic may have certain predictive value for LVH in patients with MHD.