Pan-immune-inflammation value is associated with poor prognosis in patients undergoing peritoneal dialysis

Abstract

Background

Immune-inflammatory biomarkers (IIBs) have been shown to be correlated with prognosis in patients undergoing peritoneal dialysis (PD). In this study, we aimed to evaluate the relationship between a novel comprehensive biomarker, the pan-immune-inflammation value (PIV), and the prognosis of patients undergoing PD.

Methods

We retrospectively analyzed data from a multicenter, large-sample PD database. PIV was calculated as (neutrophil count × platelet count × monocyte count)/lymphocyte count. The prognostic endpoints in this study were all-cause death all-cause, cardiovascular disease (CVD) and infection-related death. The Kaplan–Meier method, a Cox proportional hazards regression, Fine–Gray competing risk model, smooth curve, and subgroup analysis were used to analyze the independent relationship between PIV and the prognosis of patients undergoing PD.

Results

A total of 2796 cases of PD were included, and the study population was divided into Tertiles 1, 2, and 3, according to the tertiles of baseline PIVs. After adjusting for multiple model factors, patients in the Tertile 3 group had a significantly higher risk of all-cause death, CVD death and infection-related death compared with patients with PIV in the Tertile 1 group. Interaction tests showed no positive correlations for subgroup parameters. Regarding all-cause death, compared with the lowest tertile, the multivariable-adjusted hazard ratios (95% confidence intervals) of the highest and middle tertiles were 1.55 (1.25–1.94) and 1.77 (1.43–2.19), respectively; PIV (log2 processing) was associated with 17% excess of mortality in the continuous model.

Conclusions

A high PIV at baseline was significantly associated with an increased risk of deaths due to all-causes, CVD and infection in patients undergoing PD.

Keywords:

• Peritoneal dialysis
• prognosis
• pan-immune-inflammation value
• biomarker

Acknowledgments

Apart from the authors, they are no individuals and organization that have made substantial contributions to the research or the manuscript.

Institutional review board statement

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the ethics committee of our institution (jjsdyrmyy-yxyj-2021-107).

Informed consent statement

Due to the observational nature of the study, the need for written informed consent was waived.

Author contributions

Conceptualization, Xiaoran Feng; methodology, Fengping Zhang and Luohua LI; software, Luohua LI and Zhou Qian; validation, Fengping Zhang and Luohua LI; formal analysis, Fengping Zhang, Luohua LI and Zhou Qian;investigation, Fengping Zhang and Luohua LI; resources, Xianfeng Wu, Yueqiang Wen, Xiaojiang Zhan, Fen Xiaoguang Peng, Xiaoyang Wang and Xiaoran Feng; data curation, Fengping Zhang and Luohua LI; writing original draft preparation, Fengping Zhang and Luohua LI; writing review and editing, Xiaoran Feng; visualization, Fengping Zhang and Luohua LI; supervision, Xiaoran Feng; project administration: Xiaoran Feng. All authors have read and agreed to the published version of the manuscript.

Disclosure statement

The authors declare no conflict of interest.

Data availability statement

The data presented in this study are available on request from the corresponding author (Xiaoran Feng). The data are not publicly available due to ethical and institutional reasons.

Additional information

Funding

This research received no external funding.