Investigation of the effect of systemic immune inflammation index on mortality and morbidity in chronic dialysis patients.

ABSTRACT Purpose: In studies conducted in different patient groups, it has been shown that the systemic immune inflammation index has significant effects on mortality and morbidity, as well as clinical and laboratory results of patients. There are a limited number of studies conducted on this topic in dialysis patients. In our study, we aimed to investigate the effects of systemic immune inflammation index on clinical and laboratory results, mortality and morbidity in patients on chronic dialysis program undergoing dialysis at our hemodialysis center. Materials and Methods: In our dialysis center, 174 end-stage chronic kidney patients who were placed on chronic dialysis between Dec. 01.01.2014 and Dec. 15.07.2023 and entered dialysis were enrolled in the study. The relationship between SII index and gender, age, hemoglobin, CRP, ALT, AST, serum albumin, serum creatine, PTH, Kt/V, comorbid diseases and mortality was evaluated in these patients. The data have been analyzed by IBM SPSS Statistics 25 © Copyright SPSS Inc. 1989, 2017 software. The conformity of continuous variables to normal distribution was examined by Kolmogorov-Smirnov test. The categorical variables included in the study are presented with frequency (n) and percentage (%), as well as continuous variables with mean±standard deviation (SS), median (IQR 25-75) and minimum-maximum values. In the correlation analysis between continuous variables, Spearman Rho correlation analysis was used because the data did not show a normal distribution. Mann Whitney U Test was used for data that did not show normal distribution in two independent group analyses. Pearson Chi-Square Test, Fisher Exact Test and Yates Correction were used in the analysis of independent categorical variables. Logistic regression analysis was performed to determine the independent risk factors associated with the presence of CAD, CVE and Exitus. The results obtained are presented with a Odds ratio (OR) and a 95% confidence interval. The statistical significance level was accepted as 0.05 in the study. Conclusion: In our study, the SII index was found to be significantly higher in patients with diabetes mellitus, hypertension, coronary artery disease and cerebrovascular disease and in the patient group that developed mortality. SII index was seen as a factor significantly associated with serum albumin, Kt/V, CRP and hemoglobin levels. New prospective studies with larger patient series are needed so that the SII index, which we found to be a significant parameter on mortality and morbidity in hemodialysis patients, can be used as an effective marker in showing prognosis and comorbid diseases.