The advantage of the platelet-to-lymphocyte ratio over neutrophil-to-lymphocyte ratio as novel markers of erythropoietin resistance in hemodialysis patients

Sonja Golubović; Violeta Knežević; Tijana Azaševac; Dejan Ćelić

doi:10.2298/VSP210905077G

Sonja Golubović University Clinical Center of Vojvodina, Clinic for Nephrology and Clinical Immunology, Novi Sad, Serbia
Violeta Knežević University Clinical Center of Vojvodina, Clinic for Nephrology and Clinical Immunology, Novi Sad, Serbia
Tijana Azaševac University Clinical Center of Vojvodina, Clinic for Nephrology and Clinical Immunology, Novi Sad, Serbia
Dejan Ćelić University Clinical Center of Vojvodina, Clinic for Nephrology and Clinical Immunology, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP210905077G

Keywords: blood platelets, erythropoietin, inflammation, lymphocytes, neutrophils, renal dialysis

Abstract

Background/Aim. Inflammation is one of the common factors that contribute to erythropoiesis stimulating agents (ESA) treatment resistance in hemodialysis patients. Lately, it is assessed by using new markers of inflammation, which are platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR). Their association with this therapy has not been fully investigated. The aim of the study was to evaluate the relationship between PLR, NLR, and ESA hyporesponsiveness index (EHRI). Methods. The research was conducted as a cross-sectional study and included 90 hemodialysis patients, who underwent clinical and laboratory testing in the form of physical examination and biochemical analyses. In all patients, the EHRI calculation was performed. Results. It is shown that EHRI had a statistically significant positive correlation with PLR (p < 0.01) and a negative correlation with hemoglobin levels (p < 0.01). Significant differences for logarithmically converted values of EHRI and PLR (p < 0.05) were found but not for EHRI and NLR (p = 0.13). Conclusion. Research has shown that PLR, together with NLR, could be used in assessing not only inflammation but also erythropoietin resistance in hemodialysis patients.

Author Biography

Sonja Golubović, University Clinical Center of Vojvodina, Clinic for Nephrology and Clinical Immunology, Novi Sad, Serbia

+381644090506

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