Abstract: Objective  To investigate the correlation between the systemic inflammatory response index (SIRI) and cardiovascular events in patients on hemodialysis (HD).  Methods  The basic clinical information, blood routine and laboratory examination results were collected and analyzed in patients treated with regularly HD for more than 3 months in Dongguan Tungwah Hospital in the period of January 2019 to January 2021.  Results  The SIRI level was significantly higher in the cardiovascular event group than in the non-cardiovascular event group (Z=-3.558, P＜0.001). Patients in the cardiovascular event group had a higher proportion of previous cardiovascular disease, older age (χ2=-3.901, P＜0.001), and higher levels of white blood cell count (t=-3.104, P=0.002), red blood cell distribution width (t=-2.746, P=0.006), neutrophil count (t=-3.117, P=0.002), monocyte count (t=-2.492, P=0.013), triglycerides (Z=-2.508, P=0.012), C-reactive protein (Z=-2.035, P=0.042), monocyte-to-lymphocyte ratio (MLR) (Z=-2.552, P=0.011), and neutrophil-to-lymphocyte ratio (NLR) (Z= -2.277, P=0.023). COX risk proportional model analysis showed that higher SIRI level was an independent risk factor for cardiovascular events in HD patients (HR=2.307, 95% CI:1.236～4.305, P=0.009). ROC analysis showed that the area under the curve (AUC) of SIRI, MLR, and NLR were 0.676, 0.626, and 0.612, respectively, and the Youden indices were 0.326, 0.202, and 0.178, respectively, with the optimal cut-off values of 1.15, 0.35, and 4.98 respectively, sensitivity of 87.23%, 70.21%, and 40.43% respectively, and specificity of 45.31%, 50.00%, and 77.34%, respectively.  Conclusion  SIRI is an independent risk factor for cardiovascular events in HD patients.

Key words: Systemic inflammatory response index, Hemodialysis, Cardiovascular event