Inquiry. 2026 Jan-Dec;63:1. doi: 10.1177/00469580261450864. Epub 2026 May 10.
ABSTRACT
IntroductionThis research sought to understand the relationship of the neutrophil percentage-to-albumin ratio (NPAR) and mortality from cardiovascular (CVD) and all causes in populations with CKD.Methods7,553 CKD patients were included and grouped into quartiles based on NPAR. Kaplan-Meier curves were utilized for survival analysis, while a multivariate Cox proportional hazards model calculated the risk ratio of NPAR on CVD and all-cause mortality. The potential linear connection of NPAR with CVD/all-cause mortality was analyzed through restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) analysis was used to assess predictive performance. Subgroup analysis was executed with stratification according to demographic characteristics.ResultsThe Kaplan-Meier curve indicated that a higher NPAR was linked to a greater risk of CVD/all-cause mortality (p < 0.0001). In fully adjusted models, a one-unit rise in NPAR correlated with a 185% rise in the likelihood of dying from CVD diseased (HR = 2.85, 95% CI 2.26-3.47) and a 154% rise in the likelihood of dying from any cause (HR = 2.54, 95% CI 2.22-2.91). A non-linear link for NPAR and CVD/all-cause mortality was validated through RCS analysis, with a P value <0.001. ROC analysis showed that NPAR had modest discriminative ability for predicting all-cause mortality (AUC = 0.601), with an optimal cutoff value of 1.48. Across different subgroups, NPAR reliably predicted CVD and all-cause mortality in CKD patients.ConclusionElevated NPAR were linked with a higher likelihood of CVD mortality and all-cause mortality in patients with CKD and could serve as an effective prognostic biomarker.
PMID:42106959 | DOI:10.1177/00469580261450864