Association between leukocyte-based inflammatory indices and bone mineral density in hemodialysis patients

Aims: Osteoporosis and osteopenia are common among hemodialysis (HD) patients, yet current methods for risk stratification remain limited. This study aimed to investigate the relationship between leukocyte-based inflammatory indices and osteoporosis and osteopenia in HD patients and to assess their diagnostic performance in differentiating these conditions. Methods: A retrospective analysis was conducted on 168 HD patients classified into normal bone mineral density (BMD) (n=43), osteopenia (n=70), and osteoporosis (n=55) based on T-scores by dual-energy X-ray absorptiometry measurements. The leukocyte-based inflammatory indices were calculated as follows: Platelet to lymphocyte ratio (PLR)=platelet count/ lymphocyte count ratio; neutrophil o lymphocyte ratio (NLR)=neutrophil count/ lymphocyte count ratio; systemic immune inflammation index (SII)=platelet count×neutrophil count / lymphocyte count ratio, and systemic inflammation response index (SIRI)=neutrophil count×monocyte count/ lymphocyte count ratio. Results: Osteopenia and osteoporosis were identified in 41.7% and 32.7% of patients, respectively. Patients with osteoporosis exhibited higher neutrophil and monocyte counts and lower lymphocyte count (p