Abstract: Objective  To explore the predictive value of novel inflammatory markers for cardiovascular and cerebrovascular events in maintenance hemodialysis  (MHD) patients. Methods  A retrospective analysis was performed on patients who received MHD in Beijing Friendship Hospital, Capital Medical University from January 1 2019 to January 1 2024. Patients were divided into a cardiovascular and cerebrovascular event group and a non-event group based on the occurrence of such events. General data and laboratory indicators were compared between the two groups. The Mann-Whitney U test and Cox proportional hazards regression model were used to assess the relationship between inflammatory indicators and the occurrence of cardiovascular and cerebrovascular events in MHD patients. The predictive value of baseline platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) for these events was evaluated using receiver operating characteristic (ROC) curve analysis.  Results  A total of 157 patients were enrolled, among whom 42 cases (26.75%) experienced cardiovascular and cerebrovascular events. The event group had higher age (U=1905.500, P=0.043), body mass index (BMI) (t=-7.965, P＜0.001), hemoglobin (U=1744.000, P=0.008), platelet count (t=-9.416, P＜0.001), neutrophil count (U=443.500, P＜0.001), high-sensitivity C-reactive protein (hs-CRP) (U=691.000, P＜0.001), calcium (U=1872.000, P=0.031), SII (U=343.000, P＜0.001), PLR (U=721.500, P＜0.001), and neutrophil-to-lymphocyte ratio (NLR) (U=679.000, P＜0.001), but lower lymphocyte count (t=3.173, P=0.002) compared to the non-event group. SII (HR=1.001, 95% CI: 1.001～1.002, P＜0.001) and PLR (HR=1.005, 95% CI: 1.001～1.009, P=0.009) were identified as independent risk factors for cardiovascular and cerebrovascular events in MHD patients. The predictive value of SII was superior to that of PLR, with area under the curve (AUC) values of 0.837, 0.869, and 0.865 at 1-year, 3-year, and 5-year time points, respectively. The corresponding AUC values for PLR were 0.725, 0.752, and 0.784.  Conclusion  Both SII and PLR levels are associated with cardiovascular and cerebrovascular events in MHD patients, and SII has a better predictive value, which can serve as a reference indicator for early evaluation of cardiovascular and cerebrovascular events in MHD patients.

Key words: Inflammatory markers, Maintenance hemodialysis, Cardiovascular and cerebrovascular events