Hubungan Neutrophil to Lymphocyte Ratio terhadap Mortalitas dalam 1 Tahun pada Pasien yang Menjalani Hemodialisis Reguler di RS Adam Malik Medan

Abstract

Chronic kidney disease (CKD) is a global health problem with high mortality rates, especially in end-stage patients. The neutrophil to lymphocyte ratio (NLR) is known as a systemic inflammatory marker that may help predict the prognosis of hemodialysis patients. This study aimed to analyze the association between NLR and one-year mortality in CKD patients undergoing regular hemodialysis at Adam Malik General Hospital, Medan. This study used a retrospective cohort design with data collected from the medical records of 65 patients who underwent regular hemodialysis between January and December 2024. Data collected included demographic characteristics, NLR levels, and one-year mortality status. The results showed a median NLR of 2.93 (IQR 2.25), with 46.2% of patients having an NLR ≥3.5. The one-year mortality rate was 30.8%. Bivariate analysis showed a significant relationship between NLR and mortality (p = 0.01). Patients with an NLR ≥3.5 had a 4.2 times higher risk of death within one year compared to patients with an NLR <3.5 (OR = 4.229; 95% CI: 1.36–13.15). These findings support the use of NLR as a simple indicator to predict early mortality risk in CKD patients on hemodialysis. Routine monitoring of NLR is recommended as part of clinical evaluation to detect complications and improve the prognosis of regular hemodialysis patients.