ORIGINAL RESEARCH article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1612057
This article is part of the Research TopicAdvancements in Translational Models: Bridging Basic Infection Research and Clinical ApplicationsView all 4 articles
Neutrophil-to-lymphocyte ratio and CRP-to-albumin ratio in the prediction of catheter-related bloodstream infection among maintenance hemodialysis patients: a synergistical optimization algorithm
Provisionally accepted
- 1The First hospital of Hebei Medical University, Shijiazhuang, China
- 2Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, China
- 3Peking Union Medical College Hospital (CAMS), Beijing, Beijing Municipality, China
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An improved prediction method concurrently using neutrophil-to-lymphocyte ratio (NLR) and CRP-to-albumin ratio (CAR) was herein developed for catheter-related bloodstream infection (CRBSI), which is a potentially life-threatening complication in maintenance hemodialysis (MHD) patients.In a multicenter retrospective cohort study, MHD patients using central venous catheter in the past three years were divided into infected and uninfected groups by the events of CRBSI. Inter-group difference was examined by either t-test or chi-square test. Positive findings were further stepwisely explored for independent effect, diagnostic efficacy and synergistic action on the CRBSI by binary logistic regression analysis, receiver operating characteristic (ROC) curve and multiple dimensionality reduction (MDR) method, respectively. Findings up to the ROC curve were separately validated in a second cohort, which was then incorporated for the testing of MDR method.Results: Eligible patients with and without CRBSI were 140 and 249, respectively.Hemoglobin, NLR, CAR, cholesterol, ferritin and catheter type showed major inter-group differences and their independent effect on the CRBSI was confirmed by the regression analysis. These findings were literally validated in the second cohort.The ROC curve subsequently yielded a cutoff value of 6.115 for the NLR and 0.345 for the CAR. Accordingly, patients simultaneously manifesting higher NLR and CAR had the utmost risk for CRBSI as confirmed by the MDR method and vice versa.As such, NLR and CAR are inexpensive, replicable and easily measurable hematological indices for the prediction of future onset of CRBSI in asymptomatic patients, with better applicability and accuracy upon concurrent use.
Keywords: Maintenance hemodialysis, Neutrophil-to-lymphocyte ratio, CRP-to-albumin ratio, Catheter-related bloodstream infection, Central venous catheter
Received: 15 Apr 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Zhao, Yuan, Zhang, Li, Liu, Zhang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tao Wang, The First hospital of Hebei Medical University, Shijiazhuang, China
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