Is the Platelet-to-Lymphocyte Ratio a Useful Marker for Predicting Mortality in Patients Undergoing Peritoneal Dialysis? Experience from a Tertiary Care Hospital Cohort in Mexico

Background: The Platelet-to-Lymphocyte Ratio (PLR) is a low-cost biomarker that has been significantly associated with prognosis in various diseases. However, high-quality studies assessing its utility in the follow-up of patients undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD) are lacking. The objective of this study was to evaluate the usefulness of PLR in predicting one-year mortality in patients receiving renal replacement therapy with CAPD. Methods: A prospective study was conducted involving 120 CAPD patients with a dialysis duration of at least three months. Platelet and lymphocyte counts were extracted from medical records. Follow-up was conducted via telephone one year after inclusion; patients or their relatives were interviewed regarding current health status and the development of complications. Results: At the end of the follow-up period, 85 patients were successfully contacted and included in the final analysis. A mortality rate of 43% (37 patients) was observed. A statistically significant difference in PLR values was found between deceased patients and survivors (p = 0.026). ROC curve analysis yielded an area under the curve of 0.642 (95% CI, 0.517–0.767). A cutoff value of 180.34 was identified, with a sensitivity of 64.9% and specificity of 68.7%. The odds ratio (OR) was 4.06 (95% CI, 1.63–10.09), and the hazard ratio (HR) was 2.78 (95% CI, 1.41–5.48), with a two-month survival difference between the groups. Conclusion: This study demonstrated that a PLR value above 180.34 is a readily available and low-cost marker significantly associated with increased mortality risk in CAPD patients. However, its standalone predictive power is limited. Therefore, further research and the development of new protocols are warranted to explore additional associations and enhance its discriminative capacity.Survival curve separated by groups according to the Platelet-Lymphocyte ratio