RRML - Hematologic predictors of in-hospital mortality in chronic hemodialysis patients with catheter-related bloodstream infections

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ISSN online: 2284-5623

ISSN-L: 1841-6624

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Ahead of print DOI:10.2478/rrlm-2026-0005

Research article

Hematologic predictors of in-hospital mortality in chronic hemodialysis patients with catheter-related bloodstream infections

Gokhan Koker, Muhammed Ali Coskuner, Lutfullah Zahit Koc, Bilgin Bahadir Basgoz

Correspondence should be addressed to: Gokhan Koker

Abstract:

Background: Catheter-related bloodstream infections (CRBSIs) are a significant cause of morbidity and mortality in patients undergoing chronic hemodialysis. Identifying reliable prognostic markers is essential for early risk stratification and clinical decision-making. Methods: This retrospective study included 147 patients with end-stage renal disease receiving chronic hemodialysis via central venous catheter who were hospitalized with confirmed CRBSIs between 2020 and 2024. Demographic, clinical, and laboratory data were collected on admission and on the third day of hospitalization. Inflammatory markers such as white blood cell count (WBC), neutrophil count, mean platelet volume (MPV), and derived indices including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were evaluated in relation to in-hospital mortality. Results: Thirteen patients (8.8%) died during hospitalization. Age, WBC, neutrophil count, and MPV were significantly higher in the mortality group (p<0.01). While NLR and PLR on admission were not significantly different, third-day PLR values were significantly lower in non-survivors (p=0.033), showing moderate predictive performance (AUC = 0.679). Point biserial correlation and ROC analysis supported the prognostic utility of WBC, neutrophils, and PLR. Conclusions: Age, WBC, neutrophils, MPV, and third-day PLR are potential prognostic markers for in-hospital mortality in hemodialysis patients with CRBSIs. Dynamic monitoring of these hematologic indices may support early clinical decision-making.

Keywords: biomarkers, catheter-related infections, mortality, neutrophils, renal dialysis

Received: 11.7.2025
Accepted: 2.1.2026
Published: 18.1.2026

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