Abstract: 【Abstract】Objective The purpose of this study was to investigate the relationship between neutrophillymphocyte ratio(NLR) and abdominal aortic calcification (AAC) and prognosis in maintenance hemodialysis (MHD)patients. Methods The general conditions and clinical indexes of 115 MHD patients were collected. AAC was evaluated by abdominal lateral X-ray plain film. According to the abdominal aortic calcification score (AACS), the patients were divided into no or mild calcification group and moderate to severe calcification group. Logistic regression was used to analyze the risk factors of moderate to severe AAC in MHD patients. Kaplan-Meier survival method was used to analyze the difference of survival rate in patients with different levels of NLR, and COX proportional hazards model was used to analyze the risk factors of all- cause death and cardiovascular death in MHD patients. Results The mean age of 115 MHD patients was 57.8 ±13.9 years, the median dialysis vintage was 82.0 (29.0, 122.0) months, and the median AACS was 4.0 (0.0, 11.0). There were 62 cases (53.9%) in the non or mild calcification group and 53 cases (46.1%) in the moderate to severe calcification group. Logistic regression analysis showed that high NLR level was an independent risk factor for moderate to severe AAC. The median follow-up time was 72 (68, 75) months. At the end of follow- up, there were 23 all- cause deaths (20%), including 17 CVD deaths (14.8%). Kaplan- Meier analysis showed that all-cause death and cardiovascular death in patients with high NLR level were significantly higher than those with low NLR level (all-cause mortality: χ2= 4.219, P = 0.040；cardiovascular death: χ2 = 5.383, P=0.020). Multivariate COX regression analysis showed that NLR was an independent risk factor for allcause death and CVD death in MHD patients (all-cause death：HR = 1.191, 95% CI: 1.033～1.372, P=0.016; cardiovascular death：HR=1.212, 95% CI: 1.015～1.448,P=0.034). Conclusions NLR can be used as an independent predictor of moderate to severe AAC, all-cause death and cardiovascular death in MHD patients.

Key words: Hemodialysis, Neutrophil-lymphocyte ratio, Abdominal aortic calcification, Outcome