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All Journal CRJIM (Clinical and Research Journal in Internal Medicine) Deka in Medicine
Baridwan, Fakhri
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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The association of monocyte-to-lymphocyte and neutrophil-to-lymphocyte ratios with CIMT in HD and CAPD populations Baridwan, Fakhri; Samsu, Nur; Winoto, Eden
Deka in Medicine Vol. 2 No. 2 (2025): August 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e680

Abstract

BACKGROUND: Chronic kidney disease (CKD) carries a high risk of cardiovascular complications due to atherosclerosis, which is exacerbated by chronic inflammation. The neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) are emerging inflammatory markers with potential to predict atherosclerotic risk. OBJECTIVES: To evaluate the association between NLR and MLR values with carotid intima-media thickness (CIMT) in CKD patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis (CAPD). METHODS: This observational cross-sectional study was conducted at Dr. Saiful Anwar General Hospital, Malang, between July and December 2024. Data on baseline characteristics, laboratory results, and CIMT were obtained from medical records and carotid ultrasonography. Statistical analyses included t-tests, Mann-Whitney tests, and Pearson or Spearman correlation tests, depending on data distribution. RESULTS: A total of 97 CKD patients were included (45 on CAPD and 52 on hemodialysis). NLR values were significantly higher in the CAPD group compared to the hemodialysis group (p = 0.0253), while MLR did not differ significantly. CIMT was significantly higher in the hemodialysis group (p = 0.0035). In the CAPD group, MLR was significantly correlated with CIMT (r = 0.3543; p = 0.0169), whereas no significant correlation was observed in the hemodialysis group. NLR was not significantly associated with CIMT in either group. Subgroup and ROC analyses indicated that neither NLR nor MLR could accurately differentiate elevated CIMT from normal. CONCLUSION: MLR is associated with CIMT in patients undergoing CAPD, while NLR does not show a significant association with CIMT in either dialysis group.
The Comparative Value of MLR And NLR to CIMT Between HD and CAPD Patients Baridwan, Fakhri; Samsu, Nur; Winoto, Eden Suryoiman
Clinical and Research Journal in Internal Medicine Vol. 7 No. 1: Volume 7 No 1, May 2026
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2026.007.01.06

Abstract

Background: Research about the comparison of monocyte lymphocyte ratio (MLR) and neutrophil lymphocyte ratio (NLR) on Carotid Intima-Media Thickness (CIMT) between Hemodialysis (HD) and Continuous Ambulatory Peritoneal Dialysis (CAPD) patients is still very limited, therefore further research is needed. Aim: This study aims to investigate the relationship between MLR and NLR values and CIMT in HD and CAPD patients. Method: A cross-sectional observational study was conducted on 97 dialysis patients (52 HD and 45 CAPD patients) at Saiful Anwar General Hospital, Indonesia. Participants were over 18 years old, on dialysis for at least three months (HD at least twice weekly), and physically independent. Critically ill and pregnant patients were excluded. Statistical analysis was performed using Mann-Whitney test to see the difference of NLR and MLR between the two groups, Spearman test was used to analyse the correlation of NLR and MLR to CIMT in HD and CAPD. Results: This study revealed that CAPD patients had higher NLR values compared to HD patients (MD: 0.63; 95%CI: 0.07 - 1.15; p: 0.0253) and there was a significant association between MLR and increased Carotid Intima-Media Thickness (CIMT) in CKD patients undergoing CAPD (r: 0.3543; 95%CI: 0.05896 - 0.5927; p: 0.0169).   Conclusion: Our study underscores higher NLR values were found in CAPD patients compared to HD patient and the significant association between MLR values and CIMT in CAPD patients.
Co-Authors Nur Samsu Winoto, Eden Winoto, Eden Suryoiman