Dialysis adequacy is an important factor affecting the prognosis of maintenance hemodialysis (MHD) patients. The purpose of this study was to explore the risk factors affecting dialysis adequacy and the relationship between neutrophil-to-lymphocyte ratio (NLR) and dialysis adequacy in patients with MHD, and to analyze its predictive value for inadequate dialysis.

Patients with MHD who were treated in the blood purification center of our hospital from September 2020 to September 2021 were selected. The general clinical data and laboratory examination results of the patients were collected. The patients were divided into adequate dialysis group and inadequate dialysis group according to the urea clearance index (Kt/V) ≥ 1.2 and urea reduction rate (URR) ≥ 65%. The differences of each index between the two groups were compared. The risk factors of inadequate dialysis were discussed by the binary logistic regression analysis method. The receiver operating characteristic (ROC) curve was used to judge the predictive value of NLR for inadequate dialysis.

A total of 120 MHD patients were included with 71 patients in the adequate dialysis group and 49 patients in the inadequate dialysis group. Compared with the adequate dialysis group, the proportion of male patients, body mass index (BMI), NLR, and the neutrophils count were all significantly higher while high density lipoprotein (HDL) was lower in the inadequate dialysis group. Logistic regression analysis showed that male(OR 2.970, 95%CI: 1.211-7.283, P=0.017), BMI(OR 1.361, 95%CI: 1.161-1.595, P<0.001), and NLR(OR 1.310, 95%CI: 1.023-1.677, P=0.032)were risk factors for inadequate dialysis, and that the area under curve (AUC) of NLR for predicting inadequate dialysis in MHD patients was 0.635 (P<0.05).

Male, higher BMI, and higher NLR were independent risk factors for inadequate dialysis. NLR had good predictive value for inadequate dialysis and was expected to be used as an index to judge the prognosis of patients with MHD.