ORIGINAL RESEARCH article
Front. Nephrol.
Sec. Cardionephrology
Volume 5 - 2025 | doi: 10.3389/fneph.2025.1638388
Monocyte-to-lymphocyte ratio is a promising biomarker in the initial hemodialysis patients
Provisionally accepted
- Zhongshan People's Hospital (ZSPH), Zhongshan, China
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Aim: Inflammation is very common among dialysis patients and can lead to an increase in morbidity and mortality. Monocyte-to-lymphocyte ratio (MLR) can serve as a reliable predictor of long-term survival in hemodialysis patients. However, few studies have addressed the role of MLR in the initial hemodialysis patients (within 3 months). In this study, we aimed to examine the association between MLR and risk of cardiovascular and all-cause mortality in the initial hemodialysis patients. Methods: In this study, a total of 216 patients newly receiving hemodialysis for at least 3 months were recruited. The associations between MLR and cardiovascular diseases (CVD) and all-cause mortality was assessed by multivariable Cox models. Results: A total of 216 patients were included (mean age 57.65±15.68 years, 42.13% male). Patients were divided into low MLR group (<0.49) and high MLR group (≥0.49). The level of neutrophil, serum iron and the number of deaths were significantly higher in the high MLR group (P<0.05). Spearman's analysis showed that MLR was positively correlated with BUN (R=0.210, P=0.002), WBC (R=0.178, P=0.009) and neutrophil (R=0.237, P<0.001). Kaplan-Meier analysis showed that patients in the low MLR group present longer survival (64.08±2.30 vs. 51.07±3.12months, P<0.001). Multivariate Cox regression analysis showed that age, diabetes and MLR (all P<0.05) were factors significantly associated with a higher risk of CVD and all-cause mortality. Conclusions: Our results showed that high MLR values is an independent risk factor for CVD and all-cause mortality in the initial hemodialysis patients, especially in the elderly and those with a history of diabetes.
Keywords: Monocyte-to-lymphocyte ratio, hemodialysis, Mortality, biomarker, Inflammation
Received: 19 Jun 2025; Accepted: 21 Aug 2025.
Copyright: © 2025 Xie, Xiong, Yang, Tang, Tang and Lin. 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:
Bin Tang, Zhongshan People's Hospital (ZSPH), Zhongshan, China
Jieshan Lin, Zhongshan People's Hospital (ZSPH), Zhongshan, China
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