Neutrophil-to-Lymphocyte Ratio and Erythropoietin Resistance among Maintenance Hemodialysis Patients

2021 ◽  
pp. 1-6
Author(s):  
Jialing Zhang ◽  
Xiangxue Lu ◽  
Shixiang Wang ◽  
Han Li
Keyword(s):  
Pearson Correlation ◽  
Laboratory Data ◽  
Resistance Index ◽  
Maintenance Hemodialysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Pearson Correlation Analysis ◽  
Logistic Regressions ◽  
Erythropoietin Resistance ◽  
The Relationship

<b><i>Introduction:</i></b> Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are recent prognostic biomarkers associated with inflammation. Increased erythropoiesis resistance index (ERI) may predict the risk of all-cause and cardiovascular mortality in hemodialysis (HD) patients. However, the roles of NLR and PLR in erythropoietin (EPO) responsiveness remain unclear in HD patients. This study aims to investigate the relationship between NLR and PLR and EPO responsiveness in maintenance HD patients. <b><i>Methods:</i></b> A total of 299 HD patients were included in this survey. Laboratory data and demographic details were collected. EPO responsiveness was evaluated by ERI. Pearson correlation analysis and logistic regressions were conducted to evaluate the factors that may be associated with EPO responsiveness. <b><i>Results:</i></b> The EPO responsiveness was positively related to ferritin and negatively related to serum albumin, lymphocytes, and hemoglobin. A multivariate linear regression revealed that only NLR (standardized β = 0.13, <i>p</i> = 0.024) but not PLR (standardized β = 0.107, <i>p</i> = 0.063) was correlated with a higher ERI. <b><i>Conclusion:</i></b> A higher NLR level was shown to be a cheaper method to predict worse EPO responsiveness in HD patients.

Neutrophil-Lymphocyte Ratio Predicts Functional and Safety Outcomes after Endovascular Treatment for Acute Ischemic Stroke

2018 ◽  
Vol 45 (5-6) ◽  
pp. 221-227 ◽  
Author(s):  
Zhenhui Duan ◽  
Huaiming Wang ◽  
Zhen Wang ◽  
Yonggang Hao ◽  
Wenjie Zi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Functional Outcome ◽  
Laboratory Data ◽  
Poor Functional Outcome ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Relationship

Background and Objective: Endovascular treatment (EVT) is proven to be safe and effective for treating acute large vessel occlusion stroke (LVOS). The neutrophil-lymphocyte ratio (NLR) reflects systemic inflammation, which plays an important role in the process of treating ischemic stroke. This study aims to explore the relationship between NLR and the clinical outcomes of LVOS patients undergoing EVT. Methods: Patients were selected from the EVT for acUte Anterior circuLation (ACTUAL) ischemic stroke registry. The laboratory data (neutrophil count, lymphocyte count) before EVT were collected. Poor functional outcome was defined as modified Rankin Scale (mRS) of 3–6 at 3 months. Multivariable logistic regression analyses were performed to explore the relationship of NLR with functional outcome, symptomatic intracranial hemorrhage (sICH), and mortality. Results: We eventually included 616 patients (median of age, 66 years; 40.3% female). There were 350 (56.7%) patients achieving mRS of 3–6 at 3 months, 98 (15.9%) patients with sICH, and the mortality at 3 months was 24.8% (153/616). Baseline NLR was independently associated with poor functional outcome (OR 1.58; 95% CI 1.02–2.45; p = 0.039) and sICH (OR 1.84; 95% CI 1.09–3.11; p = 0.023) but showed a trend for predicting 3-month mortality (OR 1.57; 95% CI 0.94–2.65; p = 0.088). Conclusions: NLR independently predicts 3-month functional outcome and sICH but the existence of a trend association with mortality after EVT for acute anterior circulation LVOS patients.

scholarly journals Relationship of Neutrophil Lymphocyte Ratio (NLR) with Parathyroid Hormone (PTH) in Maintenance Hemodialysis Patients

2021 ◽  
Vol 7 (1) ◽  
pp. 17-25
Author(s):  
Dr. Asmita Hazra ◽  
◽  
Dr. Saptarshi Mandal ◽  
Dr. Jayati Chakraborty ◽  
◽  
...  
Keyword(s):  
Complete Blood Count ◽  
Pearson Correlation ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Maintenance Hemodialysis Patients

Background: Neutrophil-Lymphocyte-Ratio (NLR), a simple derived parameter of routine CompleteBlood Counts (CBC), has been shown to be better than WBC count as a marker for inflammation inmany contexts. Inflammation is associated with adverse outcomes in hemodialysis patients.Methods: A cross sectional study was designed on 100 maintenance hemodialysis Patients in atertiary care hospital in Eastern India after IRB permission and informed consent. 88 completeresults became available. Complete blood count (CBC), routine PTH and biochemistry analysis wereperformed. KDIGO 2009 cut offs were used to classify patients by PTH levels (PTH<2ULN, PTH 2-9ULN & PTH>9 ULN). NLR was calculated and NLR of 3.5 was used as high inflammation cut off.Results: In Analysis of 88 samples, significant Pearson Correlation with NLR was shown by Albumin,Hemoglobin, PTH, Gender, Age, and Sugar, but involved collinearities. Multiple Linear Regressionwith Robust estimation of Standard Errors retained only PTH as a significant predictor (Beta=-0.273, P=0.033) of NLR and Albumin as a borderline significant predictor (Beta= -0.501, P=0.061). The population was partitioned into 3 sets based on PTH as per KDIGO guideline.Conclusion: Our study suggests that PTH is a significant predictor of inflammation as measured byNLR, independent of the other parameters, and it has an overall weak negative association withinflammation especially in the mid-range (PTH 2-9 ULN) subgroup, which largely corroborates withavailable but scant literature.

Relationships among the Dosage of Erythropoiesis-Stimulating Agents, Erythropoietin Resistance Index, and Mortality in Maintenance Hemodialysis Patients

2021 ◽  
pp. 1-11
Author(s):  
Sai Pan ◽  
De-Long Zhao ◽  
Ping Li ◽  
Xue-Feng Sun ◽  
Jian-Hui Zhou ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Cox Regression ◽  
Resistance Index ◽  
Cox Proportional Hazards Model ◽  
Maintenance Hemodialysis ◽  
Erythropoiesis Stimulating Agents ◽  
All Cause Mortality ◽  
Erythropoietin Resistance Index ◽  
Erythropoietin Resistance

<b><i>Background:</i></b> Erythropoiesis-stimulating agents (ESAs) constitute an important treatment option for anemia in hemodialysis (HD) patients. We investigated the relationships among the dosage of ESA, erythropoietin resistance index (ERI) scores, and mortality in Chinese MHD patients. <b><i>Methods:</i></b> This multicenter observational retrospective study included MHD patients from 16 blood purification centers (<i>n</i> = 824) who underwent HD in 2011–2015 and were followed up until December 31, 2016. We collected demographic variables, HD parameters, laboratory values, and ESA dosages. Patients were grouped into quartiles according to ESA dosage to study the effect of ESA dosage on all-cause mortality. The ERI was calculated as follows: ESA (IU/week)/weight (kg)/hemoglobin levels (g/dL). We also compared outcomes among the patients stratified into quartiles according to ERI scores. We used the Cox proportional hazards model to measure the relationships between the ESA dosage, ERI scores, and all-cause mortality. Using propensity score matching, we compared mortality between groups according to ERI scores, classified as either &#x3e; or ≤12.80. <b><i>Results:</i></b> In total, 824 patients were enrolled in the study; 200 (24.3%) all-cause deaths occurred within the observation period. Kaplan-Meier analyses showed that patients administered high dosages of ESAs had significantly worse survival than those administered low dosages of ESAs. A multivariate Cox regression identified that high dosages of ESAs could significantly predict mortality (ESA dosage &#x3e;10,000.0 IU/week, HR = 1.59, 95% confidence intervals (CIs) (1.04, 2.42), and <i>p</i> = 0.031). Our analysis also indicated a significant increase in the risk of mortality in patients with high ERI scores. Propensity score matching-analyses confirmed that ERI &#x3e; 12.80 could significantly predict mortality (HR = 1.56, 95% CI [1.11, 2.18], and <i>p</i> = 0.010). <b><i>Conclusions:</i></b> Our data suggested that ESA dosages &#x3e;10,000.0 IU/week in the first 3 months constitute an independent predictor of all-cause mortality among Chinese MHD patients. A higher degree of resistance to ESA was related to a higher risk of all-cause mortality.

scholarly journals Changes in Neutrophil–Lymphocyte or Platelet–Lymphocyte Ratios and Their Associations with Clinical Outcomes in Idiopathic Pulmonary Fibrosis

2021 ◽  
Vol 10 (7) ◽  
pp. 1427
Author(s):  
Steven D. Nathan ◽  
Jayesh Mehta ◽  
John Stauffer ◽  
Elizabeth Morgenthien ◽  
Ming Yang ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Clinical Outcomes ◽  
Predictive Biomarkers ◽  
Phase Iii ◽  
Response To Treatment ◽  
Reference Ranges ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Relationship

Identification of prognostic and predictive biomarkers in idiopathic pulmonary fibrosis (IPF) could aid assessment of disease severity and prediction of progression and response to treatment. This analysis examined reference ranges for neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in IPF, and the relationship between NLR or PLR changes and clinical outcomes over 12 months. This post hoc analysis included patients with IPF from the Phase III, double-blind trials of pirfenidone, ASCEND (NCT01366209) and CAPACITY (NCT00287716 and NCT00287729). The relationship between change from baseline to Month 12 in NLR or PLR (divided into quartiles (Q1–Q4)) and outcomes (mortality, respiratory hospitalization, declines in lung function, exercise capacity and quality of life) was assessed. Estimated reference ranges at baseline for all patients analyzed (n = 1334) were 1.1–6.4 for NLR and 56.8–250.5 for PLR. Significant trends were observed across NLR and PLR quartiles for all outcomes in placebo-treated patients, with patients manifesting the greatest NLR or PLR changes experiencing the worst outcomes. These results suggest that the greatest NLR or PLR changes over 12 months were associated with worse clinical outcomes. Further research is needed to determine the utility of NLR and PLR as prognostic biomarkers in IPF.

P1379PLATELET/LYMPHOCYTE RATIO AS A MARKER OF ERYTHROPOIETIN RESPONSIVENESS IN END-STAGE RENAL DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sonja Golubović ◽  
Tijana Azasevac ◽  
Siniša Živković ◽  
Bojana Ljubiäiä‡ ◽  
Violeta Knezevic ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Laboratory Data ◽  
Moderate Intensity ◽  
Maintenance Hemodialysis ◽  
Weekly Dose ◽  
Lymphocyte Ratio ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esa Therapy

Abstract Background and Aims Neutrophil/Lymphocyte Ratio (NLR) and Platelet/Lymphocyte Ratio (PLR) are closely associated with increased inflammation in end-stage renal disease, which often contributes to the severity of anemia in these patients. Erythropoiesis stimulating agents (ESA) have become a standard treatment of anemia in hemodialysis patients. Since some patients do not respond well to erythropoietin therapy (EPO) the aim of this study is to investigate if NLR and PLR as markers of increased inflammation, could be associated with resistance to EPO therapy. Method A total of 90 patients (36 females, 54 males; mean age 60,45 ±11,58) undergoing maintenance hemodialysis and who received recombinant human EPO therapy were examined. Patients' clinical characteristics, laboratory data, dialysis adequacy and the applied doses os EPO were examined in a period of 3 months. EPO hyporesponsiveness index (EHRI) was calculated as the weekly dose of EPO divided by kilograms of body weight divided by the hemoglobin level. Results Obtained results show a statistically significant correlation of moderate-intensity between EHRI and NLR ( r = 0.497, p &lt; 0.01) as well as a negative correlation of moderate-intensity between EHRI and hemoglobin levels (Hgb) (r = -0.403, p &lt; 0.01). When it comes to the connection of NLR and PLR with logarithmically converted EHRI values, the results show that there is no statistically significant correlation between NLR and EHRI. Comparison of PLR among 25th, 50th and 75th percentile of EHRI showed that PLR levels increased going from the 25th towards the 75th percentile (p &lt; 0.01). Post hoc analysis indicated that there is also a statistically strong connection for the 25th i 50th percentile (&lt;0 .05) and furthermore for the 50th and 75th percentile (&lt; 0.05). Conclusion PLR was found to be superior to NLR in terms of evaluating ESA therapy resistance. PLR could be used as a predictor of ESA therapy response.

Visual and quantitative assessment of COVID-19 pneumonia on chest CT: The relationship with disease severity and clinical findings

2021 ◽  
Vol 17 ◽  
Author(s):  
Furkan Kaya ◽  
Petek Şarlak Konya ◽  
Emin Demirel ◽  
Neşe Demirtürk ◽  
Semiha Orhan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Disease Severity ◽  
Pearson Correlation ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Chest Ct ◽  
Laboratory Findings ◽  
Pneumonia Severity ◽  
High Attenuation ◽  
The Relationship

Background: Lungs are the primary organ of involvement of COVID-19, and the severity of pneumonia in COVID-19 patients is an important cause of morbidity and mortality. Aim: We aimed to evaluate the visual and quantitative pneumonia severity on chest computed tomography (CT) in patients with coronavirus disease 2019 (COVID-19) and compare the CT findings with clinical and laboratory findings. Methods: We retrospectively evaluated adult COVID-19 patients who underwent chest CT, clinical scores, laboratory findings, and length of hospital stay. Two independent radiologists visually evaluated the pneumonia severity on chest CT (VSQS). Quantitative CT (QCT) assessment was performed using a free DICOM viewer, and the percentage of the well-aerated lung (%WAL), high-attenuation areas (%HAA) at different threshold values, and mean lung attenuation (MLA) values were calculated. The relationship between CT scores and the clinical, laboratory data, and length of hospital stay were evaluated in this cross-sectional study. The student's t-test and chi-square test were used to analyze the differences between variables. The Pearson correlation test analyzed the correlation between variables. The diagnostic performance of the variables was assessed using receiver operating characteristic (ROC) analysis was used. Results: The VSQS and QCT scores were significantly correlated with procalcitonin, d-dimer, ferritin, and C-reactive protein levels. Both VSQ and QCT scores were significantly correlated with disease severity (p<0.001). Among the QCT parameters, the %HAA-600 value showed the best correlation with the VSQS (r=730,p<0.001). VSQS and QCT scores had high sensitivity and specificity in distinguishing disease severity and predicting prolonged hospitalization. Conclusion: The VSQS and QCT scores can help manage the COVID-19 and predict the duration of hospitalization.

Hubungan antara Penilaian Pembelajaran dengan Tingkah Laku Pegawai Agama dalam Usaha Dakwah kepada Odha di Malaysia

2016 ◽  
Vol 1 (1) ◽  
pp. 27-42
Author(s):  
Hazlin Kadir @ Shahar ◽  
Razaleigh Muhamat @ Kawangit ◽  
Rosmawati Mohamad Rasit ◽  
Badlihisham Mohd Nasir
Keyword(s):  
Correlation Analysis ◽  
Quantitative Methods ◽  
Pearson Correlation ◽  
People Living With Hiv ◽  
Strong Positive Correlation ◽  
Learning Evaluation ◽  
Pearson Correlation Analysis ◽  
Training Programmes ◽  
The Relationship ◽  
Hiv Aids

This article examines the relationship between learning and behavioural evaluation among religious officers in Malaysia after attending the Manual on HIV/AIDS in Islam Training Programmes organized by the Islamic Development Department of Malaysia (JAKIM). The training programmes were implemented to deliver the most accurate and the latest information on HIV / AIDS as well as to train religious officers in Malaysia to address the issues among Muslims. The training programmes apply the theoretical and practical activities where participants had the opportunity to carry out outreach activities with People Living with HIV / AIDS (ODHA). Quantitative methods through questionnaires were used to obtain data. A total of 350 religious officers who had attended the training programmes were selected as respondents by simple random sampling technique. Pearson correlation analysis was conducted to determine the relationship between the learning and behavioural evaluation. The results of the Pearson correlation analysis found that there was a significant relationship between learning evaluation in terms of the information obtained from programmes’ contents and behaviour evaluation with r = 0.489 and sig = 0.000 (p <0.05) at the medium positive range.. While the relationship between learning evaluation in terms of the information obtained from outreach activities with behavioural evaluation showed a strong positive correlation with the strength values obtained were r = 0.539 and sig = 0.000 (p <0.05). This analysis shows that the information acquired through the training program Manual Islam and HIV / AIDS has been successful in changing the behaviour of religious officers’ awareness in terms of the role of dakwah to ODHA. ABSTRAK Artikel ini bertujuan melihat hubungan antara penilaian pembelajaran dengan penilaian tingkah laku dalam kalangan Pegawai Agama di Malaysia setelah mengikuti Program Latihan Manual Islam dan HIV/AIDS anjuran Jabatan Kemajuan Islam Malaysia (JAKIM). Program latihan ini dilaksanakan untuk menyampaikan maklumat yang tepat serta informasi terkini isu HIV/AIDS di samping melatih Pegawai-pegawai Agama di Malaysia untuk menangani isu tersebut dalam kalangan umat Islam. Program latihan ini berbentuk teori dan praktikal di mana peserta program berpeluang melaksanakan dakwah secara temu seru (outreach) dengan Orang Yang Hidup dengan HIV/AIDS (ODHA) secara langsung. Kaedah kuantitatif melalui soal selidik telah digunakan untuk memperoleh data. Seramai 350 orang Pegawai Agama yang telah mengikuti program latihan ini dipilih sebagai responden melalui teknik pensampelan rawak mudah. Analisis korelasi Pearson dijalankan bagi mengenal pasti hubungan di antara penilaian pembelajaran dengan penilaian tingkah laku peserta yang mengikuti Program Latihan Manual Islam dan HIV/AIDS. Hasil analisis ujian korelasi Pearson tersebut mendapati bahawa terdapat hubungan yang signifikan di antara penilaian pembelajaran dari segi maklumat yang diperoleh daripada kandungan program dengan penilaian tingkah laku dengan nilai r = 0.489 dan sig = 0.000 (p<0.05). Kekuatan hubungan ialah positif sederhana. Manakala hubungan antara penilaian pembelajaran dari segi maklumat yang diperoleh daripada program temu seru dengan penilaian tingkah laku pula menunjukkan kekuatan hubungan positif kuat dengan nilai yang diperoleh ialah r = 0.539 dan sig = 0.000 (p<0.05). Analisis ini menunjukkan bahawa pembelajaran yang diperoleh melalui program latihan Manual Islam dan HIV/AIDS ini telah berjaya mengubah tingkah laku Pegawai Agama dari segi kesedaran peranan berdakwah kepada ODHA.

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