Association of Monocyte Count and Monocyte/Lymphocyte Ratio with the Risk of Cardiovascular Outcomes in Patients with CKD. Issue 4 (28th April 2022)

• Record Type: Journal Article
• Authors: Oh, Ester S.; You, Zhiying; Nowak, Kristen L.; Jovanovich, Anna J.
• Is Part Of: Kidney360. Volume 3:Issue 4(2022)
• Page Start: 657
• Page End: 665
• Publication Date: 2022-04-28
• Subjects: chronic kidney disease -- cardiovascular disease -- inflammation -- lymphocytes -- monocyte -- mortality; 616.61
• DOI: 10.34067/KID.0007922021
• Languages: English
• ISSNs: 2641-7650

Abstract

Key Points: Monocyte count and monocyte/lymphocyte ratio were associated with greater risk of cardiovascular disease (CVD), CVD death, and all-cause death in the CKD population. These findings provide evidence to enhance our understanding of the association between monocytes and CVD risk in patients with CKD. Monocyte count and monocyte/lymphocyte ratio have the potential to be clinically available indicators of cardiovascular risk in CKD. Visual Abstract: Abstract : Background: Emerging evidence suggests an association of higher monocyte count and monocyte/lymphocyte ratio (MLR) with the risk of cardiovascular disease (CVD) in individuals without chronic kidney disease (CKD); however, limited studies have examined if this association translates to the CKD population. This study examined whether monocyte count and MLR are associated with the risk of CVD, CVD death, and all-cause death in patients with nondialysis CKD who participated in the Chronic Renal Insufficiency Cohort observational study. Methods: Baseline monocyte count and MLR were categorized into tertiles and also modeled continuously. Cox proportional hazards models were used to examine the association between monocyte count (primary predictor) and MLR (secondary predictor) at baseline and time to a composite of CVD events, including heart failure, myocardial infarction, ischemic stroke, and peripheral artery disease (primary outcome). Secondary outcomes were time to CVD death and all-cause death. Results: The median follow-up time was 9 years for CVD events and 11.7 years for death. In the fully adjusted model, participants with a higher monocyte count and MLR had a greater risk of CVD events (hazard ratio [HR] per doubling of monocyte count=1.2 [95% CI, 1.1 to 1.31]; HR per doubling of MLR=1.26 [95% CI, 1.16 to 1.36]), CVD death (HR=1.18 [95% CI, 0.99 to 1.41]; HR=1.27 [95% CI, 1.1 to 1.48]), and all-cause death (HR=1.17 [95% CI, 1.06 to 1.3]; HR=1.18 [95% CI, 1.09 to 1.29]). Conclusions: These results suggest that monocyte count and MLR may have the potential to be cost-effective, clinically available indicators of CVD risk in the CKD population.