Comparison of Blood Cellular Indices Between Patients with ESRD and a Healthy Ambulatory Population

Background: End-stage renal disease (ESRD) is the advanced phase of chronic kidney disease, with only 10–15% kidney function remaining. Complete blood counts (CBCs) assess erythrocytes, leukocytes, thrombocytes, and provide differentials via automated analyzers, which yield biomarkers for inflammation, malignancy, and hematopoietic disorders. Prior studies have mainly focused on specific indices like NLR, PLR, and PMR in ESRD diagnosis and prognosis, with limited exploration of other prognostic markers. Methods: With informed consent, blood was collected into EDTA tubes for CBC analysis. Statistical and demographic data were retrieved from LUMC records post-collection. A similar IRB-approved protocol was used for healthy ambulatory subjects. Results: In the ESRD cohort, the Spearman correlation matrix revealed notable negative correlations, including SIRI–MLR (r = -0.64), SII–MLR (r = -0.64), LRR–PLR (r = -0.65), MLR–PLR (r = -0.66), and MLR–NLR (r = -0.57). Strong positive correlations were observed between SIRI and NLR (r = 0.87), dNLR (r = 0.79); SII and NLR (r = 0.87), dNLR (r = 0.79); LRR and MLR (r = 0.76); and dNLR and NLR (r = 0.96). Additional positive correlations included SIRI and NRR/MRR (r = 0.57), NPR (r = 0.56); SII and NRR/MRR (r = 0.57), NPR (r = 0.56); NPR and NLR (r = 0.62), dNLR (r = 0.67), NRR (r = 0.61); and NRR and NLR (r = 0.55), dNLR (r = 0.60). Conclusion: Despite the limitations, we have demonstrated significant differences between healthy ambulatory patients and ESRD patients. The collected data can be used for risk stratification and prediction of disease outcomes. Ultimately, more cellular indices have the ability to provide a well-rounded prognostic assessment that may prevent or provide early treatment for patients in need.Spearman correlation matrix of blood cellular indices and comorbidities in an ESRD Cohort.