Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients

Neutrophil-to-lymphocyte ratio (NLR) was introduced as a potential marker to determine inflammation in end-stage renal disease (ESRD) patients. Recently, platelet-to-lymphocyte ratio (PLR) and NLR were found to positively correlated with inflammatory markers including tumor necrosis factor- (TNF-) and interleukin (IL)-6 in cardiac and noncardiac patients. Data regarding PLR and its association with inflammation are lacking in hemodialysis (HD) and peritoneal dialysis (PD) patients. Hence, we aimed to determine the relationship between PLR, NLR, and inflammation in ESRD patients. This was a cross-sectional study involving 62 ESRD patients (29 females, 33 males; mean age, 49.6 +/- 14.6 years) receiving PD or HD for 6 months in the Dialysis Unit of Necmettin Erbakan University. PLR, NLR, C-reactive protein, TNF-, IL-6 levels were measured. PLR, NLR, serum high sensitive C-reactive protein, IL-6, and TNF- levels were significantly higher in PD patients when compared with HD patients. ESRD patients with PLR140 had significantly higher NLR, IL-6, and TNF- levels when compared to patients with PLR<139. In the bivariate correlation analysis, PLR was positively correlated with NLR, IL-6, and TNF- in this population. When we compared the association of PLR and NLR with IL-6 (r=0.371, P=0.003 vs. r=0.263, P=0.04, respectively) and TNF- (r=0.334, P=0.008 vs. r=0.273, P=0.032, respectively), PLR was found to be superior to NLR in terms of inflammation in ESRD patients. Simple calculation of PLR can predict inflammation better than NLR in ESRD patients.