Abstract: Objective   To analyze the neutrophil to lymphocyte ratio (NLR) in maintenance hemodialysis (MHD) patients using the blood access method of central venous catheterization (CVC) or arterial venous fistula (AVF).  Methods   A   total of 182 MHD patients in our department were enrolled in this study. They were divided into CVC group (n=52) and AVF group (n=130). All of them received routine hemodialysis 3 times a week for at least three months. Changes of blood cells, NLR, serum biochemical indicators, and C-reactive protein (CRP) in the follow-up period of 2 years were compared.  Results   After the follow-up period of 2 years, lymphocyte (χ2=-2.338, P=0.019), NLR (χ2=2.347, P=0.019) and CRP (χ2=2.688, P=0.007) were higher in the CVC group than in the AFV group, and serum albumin and hemoglobin were lower in the CVC group than in the AFV group. Multivariate linear regression showed that NLR was positively correlated with white blood cells (β=0.287, P＜0.001) and platelet count (β=0.944, P＜0.001). Changes of hemoglobin (χ2=2.460, P=0.015) and albumin (χ2=4.101, P<0.001) during the follow-up period of 2 years were more in the CVC group than in the AVF group.  Conclusions   Patients using CVC as the blood access for MHD have higher degrees of microinflammation, NLR, anemia and malnutrition.

Key words: Maintenance hemodialysis, Arterial venous fistula, Central venous catheterization, Inflammation, Neutrophil to lymphocyte ratio