Platelet-to-lymphocyte ratio as a potential marker for routine management of renal anemia in maintenance hemodialysis patients: A single-center observational study

Renal anemia is a common complication in maintenance hemodialysis (MHD) patients, closely linked to higher cardiovascular event risk, reduced quality of life, and poor prognosis. This study explored the correlation between novel peripheral blood inflammatory markers and renal anemia in MHD patients. A total of 142 regular MHD patients (January 2022-June 2023) were divided into renal anemia group (Hb < 110 g/L, n = 75) and non-anemia group (Hb ≥ 110 g/L, n = 67) per 2017 Kidney disease guidelines; 74 healthy controls were included. Patients with hematologic disorders, recent acute blood loss, etc, were excluded. neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were measured/calculated. Age and gender were comparable across groups (P >.05). Mann-Whitney U test, Pearson correlation, and receiver operating characteristic curve analysis were used. neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, PLR, SII were higher in both MHD groups than controls; PLR and SII were higher in anemia group than non-anemia group. All 4 markers correlated negatively with Hb. PLR and SII had diagnostic value for MHD renal anemia, with PLR being optimal (AUC = 0.844, 95% CI: 0.774-0.899, P < .001; sensitivity = 76.0%, 95% CI: 65.2%-84.3%;specificity = 85.1%, 95% CI: 74.7%-91.7%;optimal cutoff = 143.4). PLR is associated with renal anemia in MHD patients, potentially serving as an accessible screening marker. However, single-center limitation requires validation in large-scale multi-center studies before clinical promotion.