2023, Vol. 5, Issue 2, Part B

Background: Left ventricular hypertrophy (LVH), that may be seen in a vast majority of individuals at the beginning of dialysis and is closely connected with the severity of renal insufficiency, is the most prevalent cardiac abnormality in ESRD, Monocyte/lymphocyte ratio (MLR) is one of the most sensitive predictor of cardiovascular disease (CVD) events. In individuals on dialysis that are prone to asymptomatic and symptomatic infections, MLR is also an indicator of infectious problems. This study's objective was to assess MLR as a predictor of LVH in ESRD Patients on hemodialysis (HD).

Methods: The cross-sectional work was performed on 100 adults of end stage renal disease individuals receiving dialysis, both sexes participants were categorized into two groups: group I consists of 66 individuals who were diagnosed by ECHO during study to have LVH, group II included 34 patients who were diagnosed by ECHO during study not to have LVH.

Results: Echocardiographic parameters had revealed statistically significant increase in group 1 than group 2 as regards left ventricle end systolic disease (LVESD), left ventricle end dyastolic disease (LVEDD), EF, E/e′, interventricular septum (IVS), Posterior Wall Thickness (PWT), Relative wall thickness (RWT), and left ventricular mass index (LVMI). MLR was positively correlated with duration of HD, urea post dialysis, LVEDD, LVESD, left atrial dimensions (LAD), IVS, PWT, E/e′, and LVMI and negatively correlated with urea reduction ratio, systolic blood pressure post dialysis, and diastolic blood pressure post dialysis according to M/L ratio for detection of HD patients with LVH: The regression analysis revealed monocyte to lymphocyte ratio to be a good predictor of LVH in patients with ESRD on HD. At cut off value of 0.148; area under the curve was 0.785, the sensitivity was 93.93%, specificity was 85.3%, positive predictive value (PPV) was 92.53%, and negative predictive value (NPV) was 87.87%.

Conclusions: Monocyte to Lymphocyte ratio is a good, readily accessible and widespread marker for detection of LVH in ESRD patients undergoing HD.