Relationship Between Arterial Stiffness and Immature Granulocyte, Delta Neutrophil Index, and Systemic Immune-Inflammation Index in Hemodialysis Patients

INTRODUCTION: Several inflammatory markers are thought to be potential predictors of disease progression and mortality in end-stage renal disease. In the present study, for the first time in the literature, we aimed to assess the potential association between newly described inflammatory markers immature granulocyte (IG), delta neutrophil index (DNI), and systemic immune-inflammation index (SIII) and arterial stiffness (AS) in hemodialysis (HD) patients.
METHODS: Medical records of HD patients undergoing outpatient clinic were retrospectively reviewed. A single-cuff arteriograph device was used to measure AS. IG and DNI levels were determined using a specific automated hematology analyzer. SIII was calculated using the formula: (neutrophil count × platelet count) / lymphocyte count.
RESULTS: A total of 117 patients were enrolled, with a mean age of 53.6±14.5 years; 55.6% were male and 44.4% were female. Correlation analysis showed that pulse wave velocity (PWV) was strongly correlated with age, body mass index, and systolic blood pressure; positively correlated with IG and DNI; and negatively correlated with serum albumin levels. When the effect of age was eliminated in the partial correlation analysis, the relationship between PWV and inflammation markers disappeared. Regression analysis revealed that the most important determinants of PWV were age and diastolic blood pressure (DBP).
DISCUSSION AND CONCLUSION: In HD patients, PWV an indicator of arterial stiffness demonstrates an age-dependent relationship with novel inflammatory markers such as IG and DNI. These routinely obtainable hematological parameters may provide useful insight into cardiovascular risk assessment in this population.

Keywords: Arterial stiffness, Delta Neutrophil Index, Hemodialysis, Immature Granulocyte, Systemic Immune-Inflammation Index