Analysis of the effectiveness of the ratio of C-reactive protein to high-density lipoprotein cholesterol in predicting the prognosis of peritoneal dialysis patients

LAN Jing-si; ZHANG Bei-ru; BAI Yu; SHI Guo-qing; TIAN Mi; WU Yan; ZHENG Xiao-Min

doi:10.19538/j.nk2025090110

Abstract：Objective To explore the effectiveness of C-reactive protein(CRP)to high-density lipoprotein cholesterol ratio(CHR)in predicting all-cause mortality in peritoneal dialysis(PD)patients.Methods Clinical data of 283 patients who underwent peritoneal dialysis catheterization,regular dialysis,and were followed up for at least 3 months at the Peritoneal Dialysis Center of Shengjing Hospital Affiliated to China Medical University from January 1,2012 to December 31,2020 were retrospectively analyzed.The primary endpoint was all-cause mortality.Using X-tile software,patients were divided into three groups based on CHR levels:low CHR group(CHR≤ 2.847,94 cases),medium CHR group(2.847＜CHR≤5.662,72 cases),and high CHR group(CHR＞5.662,117 cases).Baseline clinical data of the three groups were compared,and Kaplan Meier method and Log rank test were used for survival analysis.Cox proportional hazards regression model was used to analyze the correlation between CHR and all-cause mortality,and subgroup analysis and interaction test were conducted to further evaluate the predictive value of CHR for patient prognosis.Results There were statistically significant differences in age,gender,BMI,cardiovascular history,hemoglobin,albumin,eGFR,CRP,triglycerides,and high-density lipoprotein cholesterol among the low CHR group,medium CHR group,and high CHR group patients(P＜0.05).For 283 patients,the median follow-up time was 26(13 to 43)months.During the follow-up process,a total of 78 patients died,including 13 deaths in the low CHR group,16 deaths in the medium CHR group,and 49 deaths in the high CHR group.The difference in the number of deaths among the three groups of patients was statistically significant(P＜0.001).The Kaplan Meier survival curve showed that the survival rate of the low CHR group was significantly higher than that of the high CHR group(Log rank P＜0.001).After the Cox proportional hazards model,it was found that the risk of all-cause mortality in the high CHR group was 2.304 times higher than that in the low CHR group(HR 2.304,95％CI,1.102-4.816,P=0.026).Subgroup analysis found that the risk of all-cause mortality in the high CHR group was still higher than that in the low CHR group in different PD patients.Interaction tests showed that the differences among different subgroups were not significant.Conclusion CHR is an independent risk factor for all-cause mortality in PD patients and an effective indicator for evaluating the prognosis of PD patients.