Clinical analysis of peripheral blood NLR and NHR in carotid atherosclerosis in patients with end-stage renal disease

Objective To investigate the clinical value of neutrophil/lymphocyte ratio (NLR) and neutrophil/high-density lipoprotein cholesterol ratio (NHR) for carotid atherosclerosis (CAS) in patients with end-stage renal disease (ESRD). Methods A total of 220 ESRD patients [glomerular filtration rate < 15 mL/(min·1.73 m2)] admitted in our department from January 2017 to January 2021 were recruited in this study. According to the results of neck color Doppler ultrasound, they were divided into CAS group (n=80) and non-CAS group (n=140). Their general data, results of blood routine test, biochemical indexes and hs-CRP level were collected, and then NLR, NHR, monocyte to high-density lipoprotein cholesterol ratio (MHR), and platelet to lymphocyte ratio (PLR) were calculated. Results The CAS group had significant older age, higher NLR, NHR, PLR and MHR, and lower hemoglobin, albumin and HDL levels when compared with the non-CAS group (P < 0.05). Multivariate logistic regression analysis showed that older age (OR=1.067, 95%CI: 1.035~1.099, P < 0.001), elevated NLR (OR=1.295, 95%CI: 1.066~1.574, P=0.009), and increased NHR (OR=2.143, 95%CI: 1.620~2.834, P < 0.001) were risk factors for CAS, and risen hemoglobin (OR=0.945, 95%CI: 0.923~0.967, P < 0.001) were protective factors for CAS in ESRD patients. ROC curve analysis indicated that NLR (AUC=0.759, 95%CI: 0.696~0.82, P < 0.000 1), NHR (AUC=0.755, 95%CI: 0.691~0.820, P < 0.000 1) and their combination (AUC=0.793, 95%CI: 0.733~0.853, P < 0.000 1) had certain predictive values for CAS in ESRD patients. Conclusion NLR and NHR, as inflammatory indexes, are independent risk factors for CAS in ESRD patients. Their combination might have better predictive value for CAS in these patients.