Association of MLR With Risk of Death and Cardiovascular Events in PD Patients
NCT ID: NCT04238338
Last Updated: 2022-04-01
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
Recruitment Status
UNKNOWN
Total Enrollment
266 participants
Study Classification
OBSERVATIONAL
Study Start Date
2020-06-01
Study Completion Date
2022-06-01
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
The current incidence of chronic kidney disease (CKD) in China is approximately 10.8%, with approximately 119 million patients. Among them, patients with end-stage renal disease (ESRD) are about 200-250 cases per million population. At present, the main renal replacement therapy is: hemodialysis (HD) or peritoneal dialysis (PD). Compared with HD, PD is easy to operate, better preserves residual renal function, has early survival advantages, and is more cost-effective. Despite this, the prognosis of PD patients is still not ideal, and cardiovascular disease (CVD) remains the leading cause of death in PD patients. Persistent inflammatory states are critical in the pathogenesis of CVD such as atherosclerosis and vascular calcification, and lead to protein energy expenditure and premature death outcomes in patients with CKD. Therefore, screening for markers that predict the risk of CVD in dialysis patients is essential. Some novel inflammatory markers have been shown to have diagnostic and prognostic value in ESRD patients in terms of inflammation, malnutrition, cardiovascular calcification, all-cause, and risk of CVD death. Among them, blood cell related parameters such as neutrophil / lymphocyte ratio (NLR) and monocyte / lymphocyte ratio (MLR)can reflect both inflammation and immune deficiency. NLR, MLR has been proposed as a new inflammatory biomarker and a potential predictor of cardiovascular risk. Studies have reported that MLR is associated with cardiovascular death and all-cause death risk in hemodialysis patients, and is superior to NLR. However, the relationship between MLR and the prognosis of patients with peritoneal dialysis is rarely reported. Therefore, in this study, we aimed to evaluate the association of MLR with risk of death and cardiovascular events in PD patients.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Survey and Reduction of Mortality in Peridialysis Uremic Patients Via Intervention of Risk Factors
NCT04088526
End Stage Renal Disease on Dialysis
UNKNOWN
NA
A Retrospective Observational Study to Describe Anaemia Management, Burden of Disease and Outcomes in Chinese Patients on Peritoneal Dialysis Using a Clinical Database
NCT04948424
Anemia
COMPLETED
Targeting Peroxisome Proliferator-activated Receptor-gamma in Peritoneal Dialysis Patients - Will it Reduce Inflammation, Atherosclerosis, Calcification and Improve Survival of Peritoneal Dialysis Patients?
NCT00516880
Chronic Disease
Kidney Diseases
Cardiovascular Diseases
UNKNOWN
NA
Interest of the Peak of Reticulocytes in Chronic Hemodialysis Patients Treated by Mircera Hemodialysis Population
NCT02832323
Renal Insufficiency, Chronic
TERMINATED
NA
Survival on Peritoneal Dialysis (PD) Versus Hemodialysis (HD) in China
NCT01413074
End Stage Renal Disease
TERMINATED
PHASE4
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
The epidemiological survey of chronic kidney disease in China shows that the current incidence of chronic kidney disease (CKD) in China is about 10.8%, with about 119 million patients. About 2% of patients will enter the stage of end-stage renal disease (ESRD) and require dialysis or kidney transplantation to support life. Currently the main renal replacement therapy is: hemodialysis (HD) or peritoneal dialysis (PD). Among them, PD patients are increasing year by year. As of 2016, more than 900,000 people in Asia are undergoing maintenance dialysis (218 cases per million population). Statistics from the CNRDS system show that as of the end of 2017, the number of PD patients in China has reached 86264. Compared with HD, PD is easy to operate, better preserves residual renal function, has early survival advantages, and is more cost-effective. In spite of this, the prognosis of PD patients is still unsatisfactory. At present, the main causes of death in PD patients are cardiovascular disease, peritoneal dialysis-related peritonitis, gastrointestinal bleeding, and tumors. Among them, cardiovascular disease (CVD) is the most important, accounting for about 50% of the deaths of PD patients. Among all CVD events, coronary heart disease, heart failure, and stroke are the most common. CVD risk factors for dialysis patients can be divided into traditional and non-traditional categories. Traditional Framingham risk factors can only explain some of the CVD risks of PD patients. Non-traditional risk factors, especially persistent inflammatory states, are essential in the pathogenesis of CVD such as atherosclerosis and vascular calcification, and lead to protein energy expenditure and premature death outcomes in patients with CKD.
The causes of chronic inflammation in patients with peritoneal dialysis are mainly divided into two aspects. Dialysis-related factors include: catheter-related infections, continuous exposure to biologically incompatible PD solutions, peritonitis, increased adipose tissue, and adipose factor balance disorders; associated with low GFR Factors include decreased clearance of pro-inflammatory factors, accumulation of uremic toxins, endotoxin exposure, oxidative stress, increased volume load, oral or other organ infections, and susceptibility to infections. The causes of inflammation in peritoneal dialysis are interconnected, leading to a persistent state of inflammation that ultimately increases the risk of cardiovascular events. Therefore, it is important to screen for markers that predict the risk of CVD in dialysis patients. At present, various inflammatory mediators, such as c-reactive protein（CRP）, interleukins（IL）and tumor necrosis factor（TNF）, have been studied and proven to independently predict the risk of CVD in dialysis patients. CRP can induce the expression of adhesion molecules in endothelial cells, increase the adhesion of vascular endothelial cells and monocytes; promote the formation of foam cells and atherosclerosis; aggravate vascular endothelial dysfunction; TNF-α can increase the expression and activity of alkaline phosphatase, enhance Isolated vascular wall calcification; aggravates vascular endothelial dysfunction; promotes left ventricular remodeling and aggravates left ventricular dysfunction. IL-6 can stimulate macrophages to secrete monocyte chemotactic protein 1, induce endothelial cell adhesion molecule expression; stimulate vascular smooth muscle cell proliferation and migration; aggravate vascular endothelial dysfunction; and induce cardiac hypertrophy. Although the mechanisms are different, they all increase the risk of CVD death in dialysis patients by aggravating vascular endothelial dysfunction, promoting ventricular remodeling and inducing myocardial hypertrophy. However, such markers are expensive and their detection is not easy to limit their clinical application. This prompted researchers to devote themselves to mining new markers of inflammation. In recent years, experts and scholars have become interested in blood cell parameters. Previous studies have shown that white blood cells and their subgroups (neutrophils, lymphocytes, monocytes) ), Neutrophil / lymphocyte ratio (NLR), monocyte / lymphocyte ratio (MLR), platelet / lymphocyte ratio (PLR) and other indicators have important predictive value for all causes and prognosis of cardiovascular disease in dialysis population . They have the advantages of low cost and easy detection. Among them, MLR has been proven to be an independent predictor of death in cardiovascular diseases such as coronary heart disease and heart failure. Previous research found. Monocytes play a key role in the occurrence and development of atherosclerosis. After the initial injury, endothelial cells are activated and promote monocytes to roll, attach and migrate under the endothelium. Monocytes that migrate to the subendothelium can differentiate into dendritic cells, which are key participants in activating adaptive immunity, or differentiate into macrophages, which secrete pro-inflammatory cytokines, thereby recruiting more immune cells and Promote inflammation. Macrophage phagocytosis of lipoprotein particles can lead to the formation of fatty streaks, the earliest ultrastructural changes in the formation of atherosclerosis. The migration of smooth muscle cells from the medial membrane to the intimal membrane further promotes the atherogenic process. Monocyte-derived cells transform this early lesion into advanced atherosclerotic plaques, which contain lipid-rich and macrophage-rich necrotic cores that eventually cause the plaque to rupture. In addition, previous studies have shown that physiological stress can lead to a significant increase in systemic cortisol production, which has led to a shift in leukocyte differentiation toward a decrease in lymphocytes and an increase in the percentage of granulocytes. Measuring lymphocyte counts can reflect stress levels. In patients with coronary heart disease, studies have shown that a decrease in lymphocyte count is an independent predictor of prognosis in patients with coronary heart disease; there is a phenomenon of lymphocyte apoptosis on the endothelium of atherosclerotic injured blood vessels. Therefore, low lymphocytes can reflect the occurrence and development of atherosclerotic diseases. In patients with end-stage renal disease, there will be changes in the number of immune cells such as increased monocytes and decreased lymphocytes. First, the decline in renal function causes retention of uremic toxins and cytokines, which leads to increased proinflammatory cytokines and oxidative stress. It further stimulates the proliferation of monocytes, and at the same time down-regulates immunity, resulting in a decrease in the number and function of lymphocytes, which in turn promotes inflammation and oxidative stress, and continues a vicious cycle. MLR can integrate pro-inflammatory and anti-inflammatory effects, and simultaneously reflect inflammation and immune deficiency. It may be an important marker of inflammation in patients with end-stage renal disease. In 2017, Xiang F et al. For the first time found in a prospective cohort study of 355 hemodialysis patients that high MLR levels were independent predictors of all-cause and CVD mortality in hemodialysis patients, and exceeded the predictive value of NLR However, there are no reports about MLR and prognosis in patients with peritoneal dialysis at home and abroad. Our previous retrospective analysis showed that the all-cause and cardiovascular disease survival rates of patients in the low MLR group were significantly higher than those in the high MLR group; high MLR levels were associated with all-cause and increased risk of cardiovascular death in patients with peritoneal dialysis. However, because retrospective studies cannot determine causality, there may be problems such as selection bias. Therefore, a prospective, large-sample study is needed to further explore the correlation between MLR and the prognosis of PD patients.
The causes of chronic inflammation in patients with peritoneal dialysis are mainly divided into two aspects. Dialysis-related factors include: catheter-related infections, continuous exposure to biologically incompatible PD solutions, peritonitis, increased adipose tissue, and adipose factor balance disorders; associated with low GFR Factors include decreased clearance of pro-inflammatory factors, accumulation of uremic toxins, endotoxin exposure, oxidative stress, increased volume load, oral or other organ infections, and susceptibility to infections. The causes of inflammation in peritoneal dialysis are interconnected, leading to a persistent state of inflammation that ultimately increases the risk of cardiovascular events. Therefore, it is important to screen for markers that predict the risk of CVD in dialysis patients. At present, various inflammatory mediators, such as c-reactive protein（CRP）, interleukins（IL）and tumor necrosis factor（TNF）, have been studied and proven to independently predict the risk of CVD in dialysis patients. CRP can induce the expression of adhesion molecules in endothelial cells, increase the adhesion of vascular endothelial cells and monocytes; promote the formation of foam cells and atherosclerosis; aggravate vascular endothelial dysfunction; TNF-α can increase the expression and activity of alkaline phosphatase, enhance Isolated vascular wall calcification; aggravates vascular endothelial dysfunction; promotes left ventricular remodeling and aggravates left ventricular dysfunction. IL-6 can stimulate macrophages to secrete monocyte chemotactic protein 1, induce endothelial cell adhesion molecule expression; stimulate vascular smooth muscle cell proliferation and migration; aggravate vascular endothelial dysfunction; and induce cardiac hypertrophy. Although the mechanisms are different, they all increase the risk of CVD death in dialysis patients by aggravating vascular endothelial dysfunction, promoting ventricular remodeling and inducing myocardial hypertrophy. However, such markers are expensive and their detection is not easy to limit their clinical application. This prompted researchers to devote themselves to mining new markers of inflammation. In recent years, experts and scholars have become interested in blood cell parameters. Previous studies have shown that white blood cells and their subgroups (neutrophils, lymphocytes, monocytes) ), Neutrophil / lymphocyte ratio (NLR), monocyte / lymphocyte ratio (MLR), platelet / lymphocyte ratio (PLR) and other indicators have important predictive value for all causes and prognosis of cardiovascular disease in dialysis population . They have the advantages of low cost and easy detection. Among them, MLR has been proven to be an independent predictor of death in cardiovascular diseases such as coronary heart disease and heart failure. Previous research found. Monocytes play a key role in the occurrence and development of atherosclerosis. After the initial injury, endothelial cells are activated and promote monocytes to roll, attach and migrate under the endothelium. Monocytes that migrate to the subendothelium can differentiate into dendritic cells, which are key participants in activating adaptive immunity, or differentiate into macrophages, which secrete pro-inflammatory cytokines, thereby recruiting more immune cells and Promote inflammation. Macrophage phagocytosis of lipoprotein particles can lead to the formation of fatty streaks, the earliest ultrastructural changes in the formation of atherosclerosis. The migration of smooth muscle cells from the medial membrane to the intimal membrane further promotes the atherogenic process. Monocyte-derived cells transform this early lesion into advanced atherosclerotic plaques, which contain lipid-rich and macrophage-rich necrotic cores that eventually cause the plaque to rupture. In addition, previous studies have shown that physiological stress can lead to a significant increase in systemic cortisol production, which has led to a shift in leukocyte differentiation toward a decrease in lymphocytes and an increase in the percentage of granulocytes. Measuring lymphocyte counts can reflect stress levels. In patients with coronary heart disease, studies have shown that a decrease in lymphocyte count is an independent predictor of prognosis in patients with coronary heart disease; there is a phenomenon of lymphocyte apoptosis on the endothelium of atherosclerotic injured blood vessels. Therefore, low lymphocytes can reflect the occurrence and development of atherosclerotic diseases. In patients with end-stage renal disease, there will be changes in the number of immune cells such as increased monocytes and decreased lymphocytes. First, the decline in renal function causes retention of uremic toxins and cytokines, which leads to increased proinflammatory cytokines and oxidative stress. It further stimulates the proliferation of monocytes, and at the same time down-regulates immunity, resulting in a decrease in the number and function of lymphocytes, which in turn promotes inflammation and oxidative stress, and continues a vicious cycle. MLR can integrate pro-inflammatory and anti-inflammatory effects, and simultaneously reflect inflammation and immune deficiency. It may be an important marker of inflammation in patients with end-stage renal disease. In 2017, Xiang F et al. For the first time found in a prospective cohort study of 355 hemodialysis patients that high MLR levels were independent predictors of all-cause and CVD mortality in hemodialysis patients, and exceeded the predictive value of NLR However, there are no reports about MLR and prognosis in patients with peritoneal dialysis at home and abroad. Our previous retrospective analysis showed that the all-cause and cardiovascular disease survival rates of patients in the low MLR group were significantly higher than those in the high MLR group; high MLR levels were associated with all-cause and increased risk of cardiovascular death in patients with peritoneal dialysis. However, because retrospective studies cannot determine causality, there may be problems such as selection bias. Therefore, a prospective, large-sample study is needed to further explore the correlation between MLR and the prognosis of PD patients.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Peritoneal Dialysis
Inflammation
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
Observational Model Type
COHORT
Study Time Perspective
PROSPECTIVE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
high MLR group
Divided into high MLR group and low MLR group according to the median of monocyte / lymphocyte ratio(MLR).
Patients undergo peritoneal dialysis 3, 4 or 5 times per day, with a daily peritoneal dialysate dose of approximately 6000-10000 ml. The glucose concentration of peritoneal dialysate varies depending on the specific requirements of the individual patient for ultrafiltration volume. Three concentrations of glucose peritoneal dialysis solution are available for peritoneal dialysis patients. The low concentration is 1.5% or 2.5% and the high concentration is 4.25%. In principle, a 1.5% glucose peritoneal dialysis solution is first applied, or a high concentration of 4.25% glucose peritoneal dialysis solution can be appropriately applied according to the actual situation. Other drugs continued to be used in patients with other diseases.
monocyte / lymphocyte ratio
Intervention Type
OTHER
The lymphocyte / monocyte ratio should be tested every 3-6months after the start of the study, and the final value is the average
low MLR group
Divided into high MLR group and low MLR group according to the median of monocyte / lymphocyte ratio(MLR).
Patients undergo peritoneal dialysis 3, 4 or 5 times per day, with a daily peritoneal dialysate dose of approximately 6000-10000 ml. The glucose concentration of peritoneal dialysate varies depending on the specific requirements of the individual patient for ultrafiltration volume. Three concentrations of glucose peritoneal dialysis solution are available for peritoneal dialysis patients. The low concentration is 1.5% or 2.5% and the high concentration is 4.25%. In principle, a 1.5% glucose peritoneal dialysis solution is first applied, or a high concentration of 4.25% glucose peritoneal dialysis solution can be appropriately applied according to the actual situation. Other drugs continued to be used in patients with other diseases.
monocyte / lymphocyte ratio
Intervention Type
OTHER
The lymphocyte / monocyte ratio should be tested every 3-6months after the start of the study, and the final value is the average
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
monocyte / lymphocyte ratio
The lymphocyte / monocyte ratio should be tested every 3-6months after the start of the study, and the final value is the average
Intervention Type
OTHER
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* Patients who underwent continuous ambulatory peritoneal dialysis for at least 3 months.
Exclusion Criteria
* Age \<18 years, with acute or chronic infections such as lung infection,peritoneal dialysis-related peritonitis, urinary system infection, etc .
* With history of malignant tumor or blood disease.
* With rheumatic immune diseases, such as systemic lupus erythematosus, vasculitis , Sjögren's syndrome, etc .
* Used immunosuppressants, such as glucocorticoids, calcineurin inhibitors, etc .
* Women during pregnancy.
* With history of malignant tumor or blood disease.
* With rheumatic immune diseases, such as systemic lupus erythematosus, vasculitis , Sjögren's syndrome, etc .
* Used immunosuppressants, such as glucocorticoids, calcineurin inhibitors, etc .
* Women during pregnancy.
Minimum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Zhujiang Hospital
OTHER
Sponsor Role
lead
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Responsibility Role
SPONSOR
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Jun Zhang, Doctor
Role: PRINCIPAL_INVESTIGATOR
Zhujiang Hospital
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Zhujiang Hospital, Southern Medical University
Guangzhou, Guangdong, China
Site Status
RECRUITING
Countries
Review the countries where the study has at least one active or historical site.
China
Central Contacts
Reach out to these primary contacts for questions about participation or study logistics.
Facility Contacts
Find local site contact details for specific facilities participating in the trial.
References
Explore related publications, articles, or registry entries linked to this study.
Lameire N, Van Biesen W. Epidemiology of peritoneal dialysis: a story of believers and nonbelievers. Nat Rev Nephrol. 2010 Feb;6(2):75-82. doi: 10.1038/nrneph.2009.210. Epub 2009 Dec 15.
Reference Type
BACKGROUND
Li PK, Chow KM, Van de Luijtgaarden MW, Johnson DW, Jager KJ, Mehrotra R, Naicker S, Pecoits-Filho R, Yu XQ, Lameire N. Changes in the worldwide epidemiology of peritoneal dialysis. Nat Rev Nephrol. 2017 Feb;13(2):90-103. doi: 10.1038/nrneph.2016.181. Epub 2016 Dec 28.
Reference Type
BACKGROUND
Saran R, Steffick D, Bragg-Gresham J. The China Kidney Disease Network (CK-NET): "Big Data-Big Dreams". Am J Kidney Dis. 2017 Jun;69(6):713-716. doi: 10.1053/j.ajkd.2017.04.008. No abstract available.
Reference Type
BACKGROUND
Cho Y, Hawley CM, Johnson DW. Clinical causes of inflammation in peritoneal dialysis patients. Int J Nephrol. 2014;2014:909373. doi: 10.1155/2014/909373. Epub 2014 May 6.
Reference Type
BACKGROUND
Akchurin OM, Kaskel F. Update on inflammation in chronic kidney disease. Blood Purif. 2015;39(1-3):84-92. doi: 10.1159/000368940. Epub 2015 Jan 20.
Reference Type
BACKGROUND
Miyamoto T, Carrero JJ, Stenvinkel P. Inflammation as a risk factor and target for therapy in chronic kidney disease. Curr Opin Nephrol Hypertens. 2011 Nov;20(6):662-8. doi: 10.1097/MNH.0b013e32834ad504.
Reference Type
BACKGROUND
Li PK, Ng JK, Mcintyre CW. Inflammation and Peritoneal Dialysis. Semin Nephrol. 2017 Jan;37(1):54-65. doi: 10.1016/j.semnephrol.2016.10.007.
Reference Type
BACKGROUND
Carrero JJ, Stenvinkel P. Inflammation in end-stage renal disease--what have we learned in 10 years? Semin Dial. 2010 Sep-Oct;23(5):498-509. doi: 10.1111/j.1525-139X.2010.00784.x.
Reference Type
BACKGROUND
Miller LM, Sood MM, Sood AR, Reslerova M, Komenda P, Rigatto C, Bueti J. Cardiovascular disease in end-stage renal disease: the challenge of assessing and managing cardiac disease in dialysis patients. Int Urol Nephrol. 2010 Dec;42(4):1007-14. doi: 10.1007/s11255-010-9857-x. Epub 2010 Oct 20.
Reference Type
BACKGROUND
Jegatheesan D, Cho Y, Johnson DW. Clinical Studies of Interventions to Mitigate Cardiovascular Risk in Peritoneal Dialysis Patients. Semin Nephrol. 2018 May;38(3):277-290. doi: 10.1016/j.semnephrol.2018.02.007.
Reference Type
BACKGROUND
Wang AY, Brimble KS, Brunier G, Holt SG, Jha V, Johnson DW, Kang SW, Kooman JP, Lambie M, McIntyre C, Mehrotra R, Pecoits-Filho R. ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I - Assessment and Management of Various Cardiovascular Risk Factors. Perit Dial Int. 2015 Jul-Aug;35(4):379-87. doi: 10.3747/pdi.2014.00279.
Reference Type
BACKGROUND
Liakopoulos V, Roumeliotis S, Gorny X, Eleftheriadis T, Mertens PR. Oxidative Stress in Patients Undergoing Peritoneal Dialysis: A Current Review of the Literature. Oxid Med Cell Longev. 2017 Dec 27;2017:3494867. doi: 10.1155/2017/3494867. eCollection 2017.
Reference Type
BACKGROUND
Saxena AB. Recent advances in the management of peritoneal dialysis patients. F1000Prime Rep. 2015 May 1;7:57. doi: 10.12703/P7-57. eCollection 2015.
Reference Type
BACKGROUND
Betjes MG. Immune cell dysfunction and inflammation in end-stage renal disease. Nat Rev Nephrol. 2013 May;9(5):255-65. doi: 10.1038/nrneph.2013.44. Epub 2013 Mar 19.
Reference Type
BACKGROUND
Ernandez T, Mayadas TN. The Changing Landscape of Renal Inflammation. Trends Mol Med. 2016 Feb;22(2):151-163. doi: 10.1016/j.molmed.2015.12.002. Epub 2016 Jan 7.
Reference Type
BACKGROUND
Johnson DW, Wiggins KJ, Armstrong KA, Campbell SB, Isbel NM, Hawley CM. Elevated white cell count at commencement of peritoneal dialysis predicts overall and cardiac mortality. Kidney Int. 2005 Feb;67(2):738-43. doi: 10.1111/j.1523-1755.2005.67135.x.
Reference Type
BACKGROUND
Li H, Lu X, Xiong R, Wang S. High Neutrophil-to-Lymphocyte Ratio Predicts Cardiovascular Mortality in Chronic Hemodialysis Patients. Mediators Inflamm. 2017;2017:9327136. doi: 10.1155/2017/9327136. Epub 2017 Feb 21.
Reference Type
BACKGROUND
Xiang F, Chen R, Cao X, Shen B, Liu Z, Tan X, Ding X, Zou J. Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all-cause mortality in hemodialysis patients: A prospective cohort study. Hemodial Int. 2018 Jan;22(1):82-92. doi: 10.1111/hdi.12549. Epub 2017 Apr 12.
Reference Type
BACKGROUND
Hou H, Sun T, Li C, Li Y, Guo Z, Wang W, Li D. An overall and dose-response meta-analysis of red blood cell distribution width and CVD outcomes. Sci Rep. 2017 Feb 24;7:43420. doi: 10.1038/srep43420.
Reference Type
BACKGROUND
Saionji K, Ohsaka A. Expansion of CD4+CD16+ blood monocytes in patients with chronic renal failure undergoing dialysis: possible involvement of macrophage colony-stimulating factor. Acta Haematol. 2001;105(1):21-6. doi: 10.1159/000046528.
Reference Type
BACKGROUND
Laudanski K, Nowak Z. Aberrant function and differentiation of monocytes in end stage renal disease. Arch Immunol Ther Exp (Warsz). 2012 Dec;60(6):453-9. doi: 10.1007/s00005-012-0191-0. Epub 2012 Oct 19.
Reference Type
BACKGROUND
Turkmen K, Guney I, Yerlikaya FH, Tonbul HZ. The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren Fail. 2012;34(2):155-9. doi: 10.3109/0886022X.2011.641514. Epub 2011 Dec 16.
Reference Type
BACKGROUND
Afari ME, Bhat T. Neutrophil to lymphocyte ratio (NLR) and cardiovascular diseases: an update. Expert Rev Cardiovasc Ther. 2016;14(5):573-7. doi: 10.1586/14779072.2016.1154788. Epub 2016 Mar 4.
Reference Type
BACKGROUND
Agarwal R, Light RP. Patterns and prognostic value of total and differential leukocyte count in chronic kidney disease. Clin J Am Soc Nephrol. 2011 Jun;6(6):1393-9. doi: 10.2215/CJN.10521110. Epub 2011 May 5.
Reference Type
BACKGROUND
Kim JH, Lim S, Park KS, Jang HC, Choi SH. Total and differential WBC counts are related with coronary artery atherosclerosis and increase the risk for cardiovascular disease in Koreans. PLoS One. 2017 Jul 28;12(7):e0180332. doi: 10.1371/journal.pone.0180332. eCollection 2017.
Reference Type
BACKGROUND
Heine GH, Ortiz A, Massy ZA, Lindholm B, Wiecek A, Martinez-Castelao A, Covic A, Goldsmith D, Suleymanlar G, London GM, Parati G, Sicari R, Zoccali C, Fliser D; European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA). Monocyte subpopulations and cardiovascular risk in chronic kidney disease. Nat Rev Nephrol. 2012 Mar 13;8(6):362-9. doi: 10.1038/nrneph.2012.41.
Reference Type
BACKGROUND
Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, Karaman M, Oguz Y, Eyileten T, Vural A, Covic A, Goldsmith D, Turak O, Yilmaz MI. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol. 2014 Aug;46(8):1619-25. doi: 10.1007/s11255-014-0730-1. Epub 2014 May 23.
Reference Type
BACKGROUND
Pereira R, Costa E, Goncalves M, Miranda V, do Sameiro Faria M, Quintanilha A, Belo L, Lima M, Santos-Silva A. Neutrophil and monocyte activation in chronic kidney disease patients under hemodialysis and its relationship with resistance to recombinant human erythropoietin and to the hemodialysis procedure. Hemodial Int. 2010 Jul;14(3):295-301. doi: 10.1111/j.1542-4758.2010.00450.x.
Reference Type
BACKGROUND
Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A, Demirtas L, Turk S, Tonbul HZ. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013 Jul;17(3):391-6. doi: 10.1111/hdi.12040. Epub 2013 Mar 24.
Reference Type
BACKGROUND
Taymez DG, Ucar E, Turkmen K, Ucar R, Afsar B, Gaipov A, Turk S. The Predictive Value of Platelet/Lymphocyte Ratio in Hemodialysis Patients With Erythropoietin Resistance. Ther Apher Dial. 2016 Apr;20(2):118-21. doi: 10.1111/1744-9987.12380. Epub 2016 Mar 1.
Reference Type
BACKGROUND
Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am J Cardiol. 1997 Mar 15;79(6):812-4. doi: 10.1016/s0002-9149(96)00878-8.
Reference Type
BACKGROUND
Zouridakis EG, Garcia-Moll X, Kaski JC. Usefulness of the blood lymphocyte count in predicting recurrent instability and death in patients with unstable angina pectoris. Am J Cardiol. 2000 Aug 15;86(4):449-51. doi: 10.1016/s0002-9149(00)00963-2. No abstract available.
Reference Type
BACKGROUND
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
Jun Zhang
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.
Effect of Different Dialysis Dosage on Prognosis in Maintenance Peritoneal Dialysis Patients
NCT00912821
COMPLETED
PHASE4
Urgent-start Peritoneal Dialysis in ESRD Patients：A Multi-center Study
NCT02946528
COMPLETED
NA
The Effect of Exercise on Blood Pressure Variability on Peritoneal Dialysis Patients
NCT07098923
COMPLETED
NA
High-flux Hemodialysis Versus Hemodiafiltration for End-Stage Renal Disease
NCT03456232
UNKNOWN
NA
The Immune System in End Stage CKD Patients - Comparison Among Different Modalities of RRT
NCT04286477
UNKNOWN
T Cell Dysfunction in ESRD
NCT04658069
UNKNOWN
Peritonitis and Loss of Residual Renal Function, Technique Failure and Mortality in Peritoneal Dialysis Patients
NCT01977716
UNKNOWN
Multi-center Clinical Study on Hemoperfusion of KHA80
NCT06233838
RECRUITING
NA
Comparison of Outcomes Between Hemodialysis and Peritoneal Dialysis Patients in a Multi-Ethnic Asian Population
NCT01587443
UNKNOWN
Incremental PD With Single Icodextrin Exchange
NCT06119373
NOT_YET_RECRUITING
NA
Hemodialysis-Induced Renal Perfusion Decline: Unraveling the Pathophysiological Mechanisms Linking Intradialytic Circulatory Stress to Residual Renal Function Loss
NCT07003828
ACTIVE_NOT_RECRUITING
Characteristics and Clinical Outcomes of Peritoneal Dialysis Patients
NCT05224466
UNKNOWN
Effect of Malnutrition on the Prognosis in Hemodialysis Patients
NCT00307983
UNKNOWN
Is Myocardial Stunning Induced by Continuous Renal Replacement Therapy a Reality in Critically Ill Patients?
NCT05209230
COMPLETED
NA
Understand the Association Between Peritoneal Dialysis Status and Gene Polymorphisms of VEGF and KDR
NCT04888065
COMPLETED
AST-120 in Hemodialysis Patients With Uremic Pruritus
NCT04639674
COMPLETED
PHASE4
Three Anticoagulation Strategies for Hemodialysis in Patients at Risk of Hemorrhage
NCT03419923
UNKNOWN
NA
Reduction of Oxalate and Inflammation by Hemodiafiltration vs. Hemodialysis
NCT02684656
COMPLETED
NA
Study of Safety and Efficacy on New Peritoneal Dialysis Solutions
NCT00858182
WITHDRAWN
PHASE2
Study Evaluating the Pronostic Value of Vascular Refilling Rate on Mortality in Chronic Kidney Disease Patients on Dialysis
NCT04810338
COMPLETED
Effect of Intradialytic Parenteral Nutrition on Morbidity and Mortality of Malnourished Hemodialysis Patients
NCT00314834
TERMINATED
PHASE4
An Observational Study of Pruritus Amongst Hemodialysis Patients
NCT00715260
UNKNOWN
Relations Between Residual Renal Function and Oxidative and Carbonyl Stress in Peritoneal Dialysis Patients
NCT00692068
COMPLETED
Risk Factors and Application of Risk Management Strategies in Hemodialysis Patients Complicated With Heart Failure
NCT06959927
COMPLETED
NA
Efficacy and Safety of a 7.5% Icodextrin Peritoneal Dialysis Solution in Once-Daily Long Dwell Exchange
NCT00725517
COMPLETED
PHASE4