Author/Authors :
Guo, Guanhua Department of Nephrology - The Second Affiliated Hospital - Guangzhou Medical University, Guangzhou, China , Zeng, Yingsi Department of Nephrology - The Second Affiliated Hospital - Guangzhou Medical University, Guangzhou, China , Chen, Qinkai Department of Nephrology - The First Affiliated Hospital of Nanchang University - Nanchang, Jiangxi, China , Zhan, Xiaojiang Department of Nephrology - The First Affiliated Hospital of Nanchang University - Nanchang, Jiangxi, China , Long, Haibo Department of Nephrology - Zhujiang Hospital - Southern Medical University, Guangzhou, China , Peng, Fenfen Department of Nephrology - Zhujiang Hospital - Southern Medical University, Guangzhou, China , Zhang, Fengping Department of Nephrology - Jiujiang NO.1 people’s Hospital, Jiangxi, China , Feng, Xiaoran Department of Nephrology - Jiujiang NO.1 people’s Hospital, Jiangxi, China , Zhou, Qian Department of Medical Statistics - Clinical Trials Unit - The First Affiliated Hospital - Sun Yat-sen University, Guangzhou, China , Wu, Xianfeng Department of Nephrology - Affiliated Sixth People’s Hospital - Shanghai Jiao Tong University, Shanghai, China , Peng, Xuan Department of Nephrology - The Second Affiliated Hospital - Guangzhou Medical University, Guangzhou, China , ETNA Evergreen Tree Nephrology Association, Guangzhou, China , Lai, Xiaochun Department of Nephrology - The Second Affiliated Hospital - Guangzhou Medical University, Guangzhou, China , Zhang,Yujing Department of Nephrology - The Second Affiliated Hospital - Guangzhou Medical University, Guangzhou, China , Wang, Zebin Department of Nephrology - The Second Affiliated Hospital - Guangzhou Medical University, Guangzhou, China , Wen, Yueqiang Department of Nephrology - The Second Affiliated Hospital - Guangzhou Medical University, Guangzhou, China , Liang, Jianbo Department of Nephrology - The Second Affiliated Hospital - Guangzhou Medical University, Guangzhou, China
Abstract :
Introduction. Though neutrophil/lymphocyte ratio (NLR) level
appears to be related with stroke events in general population, its
relationship with stroke in peritoneal dialysis (PD) patients is still
uncertain. This study aims to investigate the association between
NLR and the first occurrence of stroke in PD patients.
Methods. In this retrospective cohort study, 1507 PD patients were
enrolled from four centers in China and stratified into tertiles of NLR
levels. The incidence of the first occurrence of stroke was analyzed
by Kaplan-Meier cumulative incidence curve among different NLR
tertiles, competing risk analysis was used to calculate the incidence
of the first occurrence of stroke in the presence of competing risk of
other events, multivariable COX regression analysis was performed to
estimate the hazard ratios (HRs) for the first occurrence of stroke, as
well as forest plot was utilized to describe the relationship between
NLR and the first occurrence of stroke in different subgroups.
Results. During follow-up, 84 new-onset stroke events were recorded.
Kaplan-Meier cumulative incidence curves showed significant
differences in the incidence of the first occurrence of stroke among
three groups (log-rank test: P < .001). In competing risk analysis,
the cumulative incidence curves for tertiles of NLR levels were
highly significant for the first occurrence of stroke (P < .001), but
they were not statistically different for the occurrence of other
events. Compared to the lowest tertile of NLR level, the highest
tertile was associated with increased risk of the first occurrence of
stroke in the adjusted Cox model (HR = 2.39, 95% CI: 1.37 to 4.15;
P < .05). As for forest plot, there was no interaction in all subgroups.
Conclusion. High NLR was an independent risk factor for the first
occurrence of stroke in PD patients.
