Value of NLR and HGB levels in predicting the occurrence of HFpEF in non-dialysis CKD patients

WANG Bei; SHENG Chufan; WANG Cuocuo; ZHAO Xudong; LI Lei

doi:10.12102/j.issn.1009-6493.2025.11.007

Abstract：Objective:To study the value of the neutrophil-to-lymphocyte ratio(NLR)and hemoglobin(HGB)levels in predicting heart failure with preserved ejection fraction(HFpEF)in non-dialysis patients with chronic kidney disease(CKD).Methods:A total of 393 non-dialysis CKD patients with no previous signs or symptoms of heart failure diagnosed and treated in the Affiliated Hospital of Xuzhou Medical University from January 2022 to October 2024 were retrospectively analyzed as the study subjects.According to whether they had concurrent HFpEF,they were divided into the concurrent group(217 cases)and the non-concurrent group(176 cases).Logistic regression analysis was used to analyze the influencing factors of HFpEF in non-dialysis patients with chronic kidney disease.Sensitivity,specificity,and the area under the receiver operating characteristic curve(ROC)were used to evaluate the predictive performance of the neutrophil-to-lymphocyte ratio and hemoglobin of non-dialysis chronic kidney disease patients combined with HFpEF.Results:Multivariate Logistic regression analysis results showed that concurrent atrial fibrillation,neutrophil/lymphocyte ratio,hemoglobin,estimated glomerular filtration rate(eGFR),and BMI were influencing factors for non-dialysis chronic kidney disease patient combined with HFpEF(P<0.05).The area under the receiver operating characteristic curve of NLR for predicting non-dialysis chronic kidney disease combined with HFpEF was 0.728(95%CI 0.679-0.777,P<0.001).The sensitivity was 53.9%.And the specificity was 83.0%.The area under the ROC curve of hemoglobin for predicting non-dialysis chronic kidney disease combined with HFpEF was 0.748(95%CI 0.700-0.796).The sensitivity was 57.1%.And the specificity was 81.8%.The area under the ROC curve for the combined NLR and HGB to predict non-dialysis chronic kidney disease combined with HFpEF was 0.795(95%CI 0.751-0.838).The specificity was 77.8%.The sensitivity was 69.6%.Conclusions:The combined detection of the neutrophil-to-lymphocyte ratio and hemoglobin could provide reference for predicting whether non-dialysis patients with chronic kidney disease have concurrent HFpEF,so as to carry out early intervention and treatment and avoid further progression of the patients' condition.