Differences in Neutrophil-to-Lymphocyte Ratio, Hemoglobin, and Ferritin Between Arteriovenous Shunt and Hemodialysis Catheter in Maintenance Hemodialysis Patients
Abstract
Introduction: Vascular access type may influence systemic inflammation and hematologic profiles in patients undergoing maintenance hemodialysis. This study aimed to compare neutrophil-to-lymphocyte ratio, hemoglobin, and ferritin levels between patients using arteriovenous fistulas and hemodialysis catheters.
Methods: This cross-sectional analytical study included 128 patients undergoing maintenance hemodialysis, consisting of 85 patients with arteriovenous fistulas and 43 with hemodialysis catheters. Neutrophil-to-lymphocyte ratio and ferritin levels were compared using the Mann–Whitney U test, whereas hemoglobin levels were analyzed using the independent-samples t-test. Multiple linear regression was performed to assess the independent association between vascular access type and each laboratory parameter after adjustment for potential confounders.
Results: Patients using hemodialysis catheters had significantly higher neutrophil-to-lymphocyte ratio than those with arteriovenous fistulas (median 4.92 vs. 4.13; p=0.049). Hemoglobin levels were also higher in the catheter group (8.82 ± 1.57 vs. 8.19 ± 1.62 g/dL; p=0.038). Ferritin levels were numerically higher among catheter users but were not significantly different in unadjusted analysis (p=0.154). After multivariable adjustment, hemodialysis catheter use remained independently associated with higher neutrophil-to-lymphocyte ratio, hemoglobin, and ferritin levels.
Conclusion: Hemodialysis catheter use was associated with higher inflammatory and hematologic biomarker levels compared with arteriovenous fistula use among patients undergoing maintenance hemodialysis.
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