Medicine (Baltimore). 2026 Jun 12;105(24):e49213. doi: 10.1097/MD.0000000000049213.
ABSTRACT
Patients with end-stage renal disease (ESRD) who are on maintenance hemodialysis (HD) often experience chronic, low-level inflammation, which is closely linked to complications such as anemia, poor nutritional status, and cardiovascular issues. The purpose of this study was to assess the average level of the systemic immune-inflammation index (SII) among individuals receiving regular HD due to ESRD and to explore the clinical and laboratory variables associated with ongoing inflammatory conditions, as indicated by the SII. This descriptive cross-sectional study involved 116 patients diagnosed with ESRD who were receiving maintenance HD. Blood samples were collected and tested for complete blood count, serum albumin, lipid profile (including cholesterol, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol, and triglycerides), and high-sensitivity C-reactive protein (hs-CRP). Several inflammatory markers were derived from the complete blood count results, including the neutrophil-to-lymphocyte ratio, SII, systemic inflammation response index, and pan-immune-inflammation value. Among the 116 HD patients included in the analysis, the median SII was 498.22 (363.85-749.52). Elevated hs-CRP levels (≥3 mg/L) were observed in 35.34% of patients and were associated with clinical and laboratory characteristics such as gender, body mass index, hemoglobin, triglycerides, albumin, HDL-C, and inflammatory indices such as SII, neutrophil-to-lymphocyte ratio, systemic inflammation response index, and pan-immune-inflammation value (P < .05). hs-CRP showed a moderate positive correlation with SII (r = 0.32, P < .001) and an association with anemia, hypoalbuminemia, and dyslipidemia. Receiver operating characteristic analysis demonstrated that SII had the highest area under the curve (0.673), and the combination of high SII and low albumin significantly increased the odds of elevated hs-CRP (OR = 6.50, 95% confidence interval: 1.73-24.39, P < .05). The median SII in HD patients was 498.22, and it showed a moderate correlation with hs-CRP. The high-inflammation group (hs-CRP ≥ 3 mg/L) showed a statistically significant association with hemoglobin, albumin, triglycerides, and HDL-C (P < .05). The combination of SII and albumin improved the identification of patients at high inflammatory risk. These findings suggest that SII and the SII-albumin combination may serve as practical surrogate markers of systemic inflammation in routine dialysis care.
PMID:42299587 | DOI:10.1097/MD.0000000000049213