The Association Of Platelet To Lymphocyte Ratio With Cardiovascular And Cerebrovascular Events In Peritoneal Dialysis Patients With Chronic Renal Failure

Objective:platelet to lymphocyte ratio is a new index to reflect the inflammatory state of the body.It has been used in many diseases to evaluate the severity and prognosis,especially in cardiovascular and cerebrovascular diseases.Cardiovascular and cerebrovascular events are significantly increased in patients with chronic renal failure,which seriously threatens the quality of life of patients.However,there are few reports about the association of platelet to lymphocyte ratio with cardiovascular and cerebrovascular events in peritoneal dialysis patients with chronic renal failure.Therefore,the purpose of this study was to discuss the correlation of baseline platelet to lymphocyte ratio with cardiovascular and cerebrovascular events in peritoneal dialysis patients with chronic renal failure,to evaluate the prognosis of peritoneal dialysis patients and guide clinical treatment and prevention.Methods:This study was a single center retrospective study.The peritoneal dialysis patients were chosen in the PD center of our hospital from January 1,2010 to June30,2019,And followed up until September 30,2019.The main endpoint of the study was new cardiovascular and cerebrovascular disease after peritoneal dialysis.Based on inclusion and exclusion criteria,patients are screened in this report.And according to the baseline PLR,The three-digit method was used to divide into T1 group(low PLR group),T2 group(middle PLR group)and T3 group(high PLR group).A Kaplan-Meier curve was used to compare survival outcomes between groups,Log-Rank method was used to test the significance.The correlation between PLR and other clinical indexes was analyzed by spearman coefficient method.COX regression model was used to analyze the risk factors of cardiovascular and cerebrovascular events in peritoneal dialysis patients with chronic renal failure.P<0.05,It is considered statistically significant.Results:A total of 1195 patients were included in this study,679 were males,about 56.8percents.Mean age of the study was 48.83±14.27 years.The primary causes of end-stage renal disease are mainly chronic glomerulonephritis,about 67.0 percents.At the end of the follow-up,A total of 170 patients had cardiovascular and cerebrovascular events,263 patietns died,Cardiovascular and cerebrovascular events accounted for 53.2% of all deaths.A Kaplan–Meier curve with cardiovascular and cerebrovascular events as the end point,Compared to the low PLR group,The high PLR group had a higher incidence of cardiovascular and cerebrovascular events(Log Rank=11.998,P<0.05),The difference was statistically significant.Spearman coefficient analysis suggested that PLR was positively correlated with neutrophils,Low-density lipoprotein,C reactive proteins,PLR is negatively correlated with albumin.In multiple COX regression analysis,after adjustment for male,age,systolic blood pressure,diabetes,hypertension,pre-dialysis CVD,hemoglobin,albumin,C reactive protein and PLR,The risk of cardiovascular and cerebrovascular events was higher in the high PLR group(HR=1.598,95% CI:1.029-2.482)compared with the low PLR group.Age and C reactive protein are also independent risk factors for cardiovascular and cerebrovascular events in peritoneal dialysis patients.Conclusions:(1)platelet/lymphocyte ratio was positively correlated with neutrophils,C reactive proteins,and negatively correlated with albumin,indicating that it could reflect the inflammatory level of the body.(2)High PLR,C reactive protein and age are associated with cardiovascular and cerebrovascular events in peritoneal dialysis patients.