Zhongguo quanke yixue (Oct 2024)
Correlation between Systemic Immune-inflammation Index and Erythropoietin Hypo-responsiveness in Patients with Maintenance Hemodialysis
Abstract
Background Erythropoietin (EPO) hypo-responsiveness is one of the main reasons for the low compliance rate of renal anemia in maintenance hemodialysis (MHD) patients, and it is also an independent risk factor for death in MHD patients. Early identification and early intervention is the key to improve prognosis. Blood inflammatory markers may be associated with EPO hypo-responsiveness in MHD patients. Objective To explore the correlation between systemic immune-inflammation index (SII) and EPO hypo-responsiveness in MHD patients. Methods A total of 180 patients who underwent regular MHD at the hemodialysis center of Henan Province Hospital of Traditional Chinese Medicine from June 2022 to June 2023 were selected as the study objects. EPO resistance index (ERI) was used to evaluate the EPO reactivity of the patients, and they were divided into EPO hypo-responsiveness group and non-EPO hypo-responsiveness group according to the ERI value. The general data and laboratory index data of the two groups were compared. Pearson correlation analysis and Spearman rank correlation analysis were used to assess the correlation of ERI with other various indicators. Multivariate Logistic regression analysis was used to explore the independent correlation factors of EPO hypo-responsiveness in MHD patients. The predictive value of SII for EPO hypo-responsiveness in MHD patients was analyzed using receiver operating characteristic (ROC) curves. Results A total of 180 patients with MHD were included, including 104 males (57.8%) and 76 females (42.2%), aged (56.1±8.6) years. There were 52 cases (28.9%) in EPO hypo-responsiveness group and 128 cases (71.1%) in non-EPO hypo-responsiveness group. There were significant differences in dialysis age, post-dialysis body weight, weekly rHuEPO dosage, white blood cells, neutrophils, lymphocytes, red blood cells, hemoglobin, platelets, albumin, parathyroid hormone, triglyceride, ERI, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and SII between EPO hypo-responsiveness group and non-EPO hypo-responsiveness group (P<0.05). Correlation analysis results showed that ERI in MHD patients was positively correlated with weekly rHuEPO dosage, white blood cells, neutrophils, platelets, blood uric acid, blood phosphorus, serum ferritin, NLR, PLR and SII [r (rs) =0.486, 0.355, 0.348, 0.294, 0.198, 0.270, 0.167, 0.258, 0.302, 0.317, P<0.05] ; It was negatively correlated with body weight, erythrocyte, hemoglobin and albumin [r (rs) =-0.407, -0.502, -0.627, -0.342, P<0.05]. Multivariate Logistic regression analysis showed that SII was one of the independent correlation factors for EPO hypo-responsivenes in MHD patients (OR=1.003, 95%CI=1.001-1.004, P<0.001). ROC curve analysis showed that the AUC of SII for predicting EPO hypo-responsiveness in MHD patients was 0.745 (95%CI=0.660-0.831), sensitivity was 61.5%, specificity was 79.7%, and the best cutoff value was 650.61. Conclusion SII is an independent correlation factor of EPO hypo-responsiveness in MHD patients, and has high clinical value in predicting EPO hypo-responsiveness in MHD patients.
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