The relationship between neutrophil/lymphocyte ratio, dietary inflammatory index, and quality of life in hemodialysis patients

Background and Aim: Chronic inflammation is a common condition observed in hemodialysis patients and plays a significant role in the progression of accompanying comorbidities and the deterioration of quality of life. Systemic inflammation markers such as the neutrophil-to-lymphocyte ratio (NLR) and dietary inflammatory indices like the Dietary Inflammatory Index (DII), which measure the inflammatory potential of the diet, may be associated with clinical outcomes and patient well-being. The aim of this study is to determine inflammation markers, inflammatory scores, nutritional status, and quality of life in patients undergoing hemodialysis treatment, and to examine the relationships among these factors. Material and Methods: This study included 59 hemodialysis patients undergoing treatment. Sociodemographic characteristics, blood biochemical parameters, dietary habits, anthropometric measurements, and quality of life data were collected from participants. The Dietary Inflammatory Index was calculated using dietary data obtained from three-day food consumption records. Systemic inflammation was assessed using NLR, PLR (platelet-to-lymphocyte ratio), and CRP/albumin levels. Quality of life was measured using the SF-36 questionnaire. Results: The mean age of the 59 hemodialysis patients included in the study was 60.7 ± 13.6 years, and 52.5% were male. A statistically significant negative correlation was found between the Dietary Inflammatory Index (DII) and serum albumin levels (r = –0.365, p = 0.005), while a positive correlation was observed between DII and the CRP/albumin ratio (r = 0.336, p = 0.010). Additionally, the neutrophil-to-lymphocyte ratio (NLR) was positively correlated with both the CRP/albumin ratio (r = 0.279, p = 0.034) and the platelet-to-lymphocyte ratio (PLR) (r = 0.609, p <0.001). Regarding quality of life, a significant negative correlation was found between DII and the "general health" subscale of the SF-36 questionnaire (r = –0.295, p = 0.023). Furthermore, higher CRP/albumin ratios were associated with lower scores in the "physical functioning" and "vitality" subscales (p <0.05). These findings suggest that diet-related inflammation and systemic inflammatory markers are associated with both nutritional status and quality of life in hemodialysis patients. Conclusion: This study demonstrates a significant relationship between dietary inflammatory potential and systemic inflammation in hemodialysis patients. Additionally, both DII and NLR were inversely associated with quality of life. Improving the dietary inflammatory profile may be an important strategy to reduce inflammation and enhance quality of life in this patient population.