Is the neutrophil-to-lymphocyte ratio associated with arteriovenous fistula dysfunction in hemodialysis patients?
In a small cross-sectional study, the neutrophil-to-lymphocyte ratio was not significantly associated with arteriovenous fistula dysfunction in hemodialysis patients.
Introduction: End-stage renal disease (ESRD) represents one of the major public health problems of the 21st century, due to its high prevalence and increasing incidence due to increased longevity of the population and the reduced capacity for treating kidney disease. It has become a chronic condition with significant health, social, and economic impact. Given these growing data, it is essential to maintain adequate vascular access function, which is a cornerstone of renal replacement therapy (RRT). Regarding arteriovenous fistulas (AVFs), these are the most efficient vascular accesses in the field of hemodialysis, and their dysfunction develops over variable time intervals. Therefore, adequate monitoring and control of risk factors can prolong vascular access survival. Accessible and affordable predictive factors for dysfunction are required, providing us with the opportunity to take preventive action and treat the possible causes of (AVF) dysfunction. Recently, the relationship between neutrophil and lymphocyte count (NLR) has been examined as a risk factor for (AVF) dysfunction in patients undergoing hemodialysis-type renal replacement therapy. Methods: A non-experimental, descriptive-correlational, crosssectional design. Thirty patients were included for the calculation of the (NLR). These patients had data on dysfunction in their medical records (AVF) Doppler ultrasound reports and blood counts. SPSS version 20 was used for data processing. Results: It was evident that among the factors associated with (AVF) dysfunction, 32. 1% of the study population had systemic arterial hypertension and 28. 6% had type 2 diabetes mellitus. Regarding nutritional status according to the body mass index (BMI), 35. 7% were overweight and 7. 1% were obese; only 7. 1% of the population had dyslipidemia. The location with the highest incidence of dysfunction was the brachiocephalic region (28. 6%), of which 32. 1% was associated with thrombosis. Regarding the relationship between the probability of (AVF) dysfunction and the neutrophil/lymphocyte ratio, 39. 3% had a cutoff point of (NLR 2. 7), which contrasts with previously conducted studies that contrast with vascular access dysfunction. However, no significant association was found between these two variables (p = 0. 053). Conclusion: These findings suggest that, although there is a trend that could link (NLR) with arteriovenous fistula dysfunction, the lack of a statistically significant association indicates the need for additional studies with larger samples and more robust designs. Furthermore, it is crucial to continue investigating other accessible and affordable predictive factors that may aid in the prevention and management of (AVF) dysfunction. Therefore, continuous monitoring of vascular access and the identification of risk factors are essential to improve the quality of life of hemodialysis patients and optimize renal replacement therapy. I have no potential conflict of interest to disclose. I did not use generative AI and AI-assisted technologies in the writing process.
Bahari et al. (Wed,) studied this question.