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The following is a summary of “Association between neutrophil percentage-to-albumin ratio and mortality in Hemodialysis patients: insights from a prospective cohort study,” published in the March 2025 issue of BMC Nephrology by Zhu et al. 

Neutrophil percentage-to-albumin ratio (NPAR) is a novel inflammation marker with prognostic value in cardiovascular diseases. Its role in mortality among patients with maintenance hemodialysis (MHD) remains unclear. 

Researchers conducted a retrospective study to assess NPAR as a mortality predictor in patients with MHD. 

They recruited 1,803 patients with MHD and stratified them into three groups by baseline NPAR levels. They used multivariate Cox proportional risk model and sensitivity analysis to assess NPAR’s association with all-cause and cardiovascular mortality. They evaluated predictive performance using receiver operating characteristic (ROC) curves, comparing NPAR with neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil count, and serum albumin. They compared area under the curve (AUC) values using DeLong’s test. 

The results showed that over a 28-month median follow-up, 239 (13.3%) patients died, including 91 (5.0%) from cardiovascular disease. High NPAR was linked to increased all-cause and cardiovascular mortality. Adjusted hazard ratios were 1.550 (95% CI: 1.110–2.166, P = 0.010) for all-cause mortality and 1.844 (95% CI: 1.058–3.212, P = 0.031) for cardiovascular mortality. AUC values for NPAR were 0.612 (95% CI: 0.572–0.652, P < 0.001) and 0.618 (95% CI: 0.557–0.678, P < 0.001), respectively. P-values comparing NPAR’s AUC with NLR, PLR, neutrophils, and albumin were 0.307, 0.094, 0.014, and 0.154 for all-cause mortality, and 0.879, 0.126, 0.119, and 0.596 for cardiovascular mortality. 

Investigators found that high NPAR was independently associated with an increased risk of death in patients with MHD. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-025-04027-0