Association of neutrophil-to-lymphocyte-platelet ratio with residual renal function in early-stage peritoneal dialysis patients

Background To investigate the association between the neutrophil-to-lymphocyte-platelet ratio (NLPR) and residual renal function (RRF) in early-stage peritoneal dialysis (PD) patients, and to evaluate its association with for RRF decline. Methods This retrospective study included PD patients treated between January 2025 and February 2026. Patients were divided into an early group (dialysis duration 3–12 months) and a late group (>12 months). One extreme NLPR outlier was excluded from the early group, resulting in 23 patients in the early group and 49 in the late group. Spearman’s correlation, linear regression, and ROC curve analysis were used. Results In the early group, NLPR was significantly negatively correlated with residual renal Ccr ( r = -0.559), residual renal Kt/V ( r = -0.465), eGFR ( r = -0.471), nPCR ( r = -0.515), and target Kt/V achievement ( r = -0.448) (all p < 0.05). Univariate linear regression showed that NLPR significantly predicted residual renal Ccr (B = -1.502, p = 0.006), and it remained independently predictive after adjusting for nPCR (B = -1.592, p = 0.011). ROC curve analysis demonstrated good discriminatory ability for predicting lower RRF, with an AUC of 0.818 (95% CI 0.640-0.996, p = 0.010). The optimal cut-off was 10.372, with 81.8% sensitivity and 58.3% specificity. Subgroup analysis showed a stronger association in males (r = -0.796, p = 0.006). Conclusions NLPR is significantly associated with RRF in early-stage PD patients. Although it demonstrated good discriminatory ability for RRF status in this cross-sectional study, its predictive value for RRF decline warrants further validation in longitudinal cohort studies.