Abstract: Objective  To investigate the correlation of serum levels of macrophage inflammatory protein-1α (MIP-1α), chitinase-3-like protein 1 (YKL-40), and NOD like receptor family pyrin domain-containing protein 3 (NLRP3) with catheter-related infections and prognosis in maintenance hemodialysis (MHD) patients.  Methods A total of 296 MHD patients treated in Luzhou Hospital of Traditional Chinese Medicine from January 2020 to August 2024 were included in this study. They were divided into infected group (n=68) and uninfected group (n=228) based on the presence or absence of catheter infection. The catheter infection patients were further divided into good prognosis subgroup (n=42) or poor prognosis subgroup (n=26). ELISA was applied to detect serum levels of MIP-1α, YKL-40, and NLRP3. Clinical data were collected and analyzed. Multivariate logistic regression was applied to analyze the factors influencing prognosis. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of MIP-1α, YKL-40, and NLRP3 for prognosis. Pearson and Spearman methods were applied to analyze the correlation of MIP-1α, YKL-40 and NLRP3 with inflammatory factors and prognosis.  Results  Compared with the uninfected group, the infected group had obviously higher levels of serum MIP-1α, YKL-40, NLRP3, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and procalcitonin (PCT) (t=14.532, 14.561, 22.823, 28.495, 11.487 and 22.234 respectively; P<0.001). Dialysis duration (t=3.293, P=0.002), dialysis frequency (t=3.293, P=0.001), MIP-1α (t=8.410, P＜0.001), YKL-40 (t=7.432, P＜0.001), NLRP3 (t=7.511, P＜0.001), CRP (t=15.045, P＜0.001), TNF-α (t=3.694, P＜0.001) and PCT (t=4.007, P＜0.001) levels in the poor prognosis subgroup were obviously higher than those in the good prognosis subgroup. ROC curve showed that the AUC of combined use of MIP-1α, YKL-40 and NLRP3 levels for predicting prognosis was obviously higher than that of single use of MIP-1α (Z=2.101, P=0.036), YKL-40 (Z=2.610, P=0.009) or NLRP3 (Z=2.965, P=0.003). MIP-1α, YKL-40, and NLRP3 were positively correlated with the inflammatory factors of CRP (r=0.462, 0.466 and 0.472 respectively; P＜0.001), TNF-α (r=0.450, 0.444 and 0.455 respectively; P＜0.001), and PCT (r=0.521, 0.502 and 0.504 respectively; P＜0.001), and with prognosis (r=0.521, 0.502 and 0.504 respectively; P＜0.001).   Conclusion Serum MIP-1α, YKL-40 and NLRP3 levels correlate with catheter-related infections and prognosis in MHD patients.

Key words: Maintenance hemodialysis, Macrophage inflammatory protein-1α, Chitinase-3-like protein 1, NOD like receptor family pyrin domain-containing protein 3, Catheter-related infection, Prognosis