Relationship between glucose to lymphocyte ratio and the first peritonitis episode in patients treated with peritoneal dialysis

This study aimed to investigate the potential relationship between baseline glucose to lymphocyte ratio (GLR) levels and the first episode of peritonitis in patients treated with peritoneal dialysis (PD). A total of 314 patients treated with PD were included and divided into three groups based on GLR tertiles: tertile 1 (GLR ≤ 4.23); tertile 2 (4.23 < GLR ≤ 5.96), and tertile 3 (GLR > 5.96). The relationships between GLR and the first peritonitis episode were analyzed using Kaplan-Meier curves and multivariable Cox regression models. Competitive risk analysis, subgroup and sensitivity analyses were performed to validate the robustness of the findings. During a median follow-up of 27 months, 123 (39.17%) patients developed the first episode of peritonitis. The incidence of the first peritonitis episode increased with the higher GLR tertiles (tertile 1: 32.08%, tertile 2: 37.50%, tertile 3: 48.08%). Kaplan-Meier curves revealed significant differences in the cumulative incidence of the first peritonitis episode among the GLR tertiles (Log-Rank test, P = 0.018). After full adjustment for confounding factors, patients in tertile 3 remained at significantly higher risk for the first episode of peritonitis compared to those in tertile 1 (HR 2.633, 95% CI 1.223-5.668, P = 0.013). Competitive risk models and sensitivity analysis further confirmed this association. Our study suggests that elevated GLR is associated with an increased risk of the first peritonitis episode in patients with PD.