Indonesian Journal of Kidney and Hypertension
Vol 3 No 2 (2026): Volume 3 No. 2 August 2026

Differences in Neutrophil-to-Lymphocyte Ratio, Hemoglobin, and Ferritin Between Arteriovenous Shunt and Hemodialysis Catheter in Maintenance Hemodialysis Patients

Gerry Febrian Rizaldi (Sebelas Maret University)
Ratih Tri Kusuma Dewi (Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital, Surakarta, Indonesia)
Didik Prasetyo (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital, Surakarta, Indonesia)
Dhani Redhono (Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital, Surakarta, Indonesia)
Eti Poncorini Pamungkasi (Department of Public Health and Medical Education, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia)



Article Info

Publish Date
24 Aug 2026

Abstract

Introduction: Vascular access type may influence systemic inflammation and hematologic profiles in patients undergoing maintenance hemodialysis. This study aimed to compare neutrophil-to-lymphocyte ratio, hemoglobin, and ferritin levels between patients using arteriovenous fistulas and hemodialysis catheters. Methods: This cross-sectional analytical study included 128 patients undergoing maintenance hemodialysis, consisting of 85 patients with arteriovenous fistulas and 43 with hemodialysis catheters. Neutrophil-to-lymphocyte ratio and ferritin levels were compared using the Mann–Whitney U test, whereas hemoglobin levels were analyzed using the independent-samples t-test. Multiple linear regression was performed to assess the independent association between vascular access type and each laboratory parameter after adjustment for potential confounders. Results: Patients using hemodialysis catheters had significantly higher neutrophil-to-lymphocyte ratio than those with arteriovenous fistulas (median 4.92 vs. 4.13; p=0.049). Hemoglobin levels were also higher in the catheter group (8.82 ± 1.57 vs. 8.19 ± 1.62 g/dL; p=0.038). Ferritin levels were numerically higher among catheter users but were not significantly different in unadjusted analysis (p=0.154). After multivariable adjustment, hemodialysis catheter use remained independently associated with higher neutrophil-to-lymphocyte ratio, hemoglobin, and ferritin levels. Conclusion: Hemodialysis catheter use was associated with higher inflammatory and hematologic biomarker levels compared with arteriovenous fistula use among patients undergoing maintenance hemodialysis.

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Journal Info

Abbrev

inakidney

Publisher

Subject

Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

Description

The primary mission of this journal is to serve as a conduit for the dissemination of both clinical and foundational research pertinent to the expansive domains of nephrology and hypertension. Spanning a diverse array of topics, the journal delves into multifaceted areas including but not limited to ...