Clinical Value of Serum PTH and NLR in Predicting Vascular Access Complications in Elderly Patients on Maintenance Hemodialysis

doi:10.3969/j.issn.1004-5775.2025.05.014

Abstract：Objective: To explore the clinical value of serum parathyroid hormone (PTH) and neutrophil-to-lymphocyte ratio (NLR) in predicting vascular access complications in elderly patients on maintenance hemodialysis (MHD). Methods: A total of 41 elderly MHD patients treated at Rundong County People's Hospital from October 2023 to March 2024 were selected as the observation group, and 41 healthy individuals during the same period were selected as the control group. The Mini-Nutritional Assessment (MNA) was used to evaluate the nutritional status of the study subjects. Serum PTH, neutrophil (NEUT), and lymphocyte (LY) levels were measured, and the NLR levels of the two groups were compared. According to whether vascular access complications such as poor blood flow, thromboembolism, upper limb numbness, and arm swelling occurred, the observation group was divided into a complication group and a non-complication group. The differences in various indicators between the two groups were compared, and logistic regression analysis was used to assess the risk factors for complications. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to analyze the diagnostic efficiency of each indicator for vascular access complications in elderly MHD patients. Results: The MNA score and LY level of the observation group were lower than those of the control group, while the PTH, NEUT, and NLR levels of the observation group were higher than those of the control group, with statistically significant differences (t=22.78, 78.07, 12.21, 8.41, 12.70, P<0.05). There were statistically significant differences in MNA score, serum PTH, NEUT, LY, and NLR levels between the two groups (t=7.27, 17.18, 5.55, 4.01, 7.48, P<0.05). MNA score, NEUT, LY, PTH, and NLR levels were independent factors influencing the occurrence of complications in elderly MHD patients (P<0.05). The ROC curve of PTH combined with NLR for predicting complications in the observation group showed an AUC of 0.952, with a sensitivity of 91.40% and a specificity of 94.40%. Compared with single indicators, the combined detection had higher predictive efficacy. Conclusion: The occurrence of vascular access complications in elderly MHD patients is closely related to serum PTH and NLR levels, and the combination of PTH and NLR can play an important role in prognosis assessment and treatment guidance.