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. 2025 Nov 9;15(11):1728.
doi: 10.3390/life15111728.

Prognostic Value of Fibrinogen-to-Albumin Ratio and Neutrophil-to-Lymphocyte Ratio in Patients on Peritoneal Dialysis

Selena Gajić  1 , Ana Bontić  1   2 , Aleksandar Sič  2 , Vidna Karadžić-Ristanović  1 , Milorad Stojadinović  1 , Kristina Filić  1 , Jelena Pavlović  1   2 , Jovana Gavrilović  1 , Kristina Petrović  1 , Sanja Stanković  3   4 , Nikola Trnić  2 , Filip Simović  2 , Pavle Popović  5 , Svetlana Jovičić-Pavlović  1 , Aleksandra Kezić  1   2 , Marko Baralić  1   2
Affiliations

Prognostic Value of Fibrinogen-to-Albumin Ratio and Neutrophil-to-Lymphocyte Ratio in Patients on Peritoneal Dialysis

Selena Gajić et al. Life (Basel). .

Abstract

Background and objectives: Chronic inflammation (CIn) is common among peritoneal dialysis (PD) patients and contributes to adverse outcomes. However, the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and fibrinogen-to-albumin ratio (FAR) in PD remains uncertain.

Methodology: In this prospective cohort study, 65 PD patients were followed for 18 months. Baseline demographic, clinical and laboratory data were collected and inflammatory indices were calculated. The composite outcome was all-cause mortality or transfer to hemodialysis (HD). Logistic regression analyses were used to identify independent predictors of outcomes.

Results: Over the 18-month follow-up, 23 patients (35.4%) died and 13 (20.0%) transferred to HD. Patients with adverse outcomes had higher baseline FAR, C-reactive protein (CRP) and serum glucose (Glc) levels and lower triglycerides (TG). In multivariate analysis, higher FAR (OR 5.28, 95% CI 1.16-24.12), CRP (OR 1.28, 95% CI 1.02-1.62) and PTH (OR 1.01, 95% CI 1.00-1.01) were independently associated with adverse outcomes, while NLR showed marginal significance. In the mortality-only model, FAR (OR 3.99, 95% CI 1.17-13.61) and PTH remained significant predictors.

Conclusions: FAR demonstrated a significant prognostic association with mortality and composite adverse outcomes in PD patients, whereas NLR had limited predictive value. Albumin-based inflammatory indices such as FAR may complement established markers for risk stratification. Larger multicenter studies are warranted to validate these findings.

Keywords: chronic inflammation; fibrinogen-to-albumin ratio; inflammatory markers; mortality; neutrophil-to-lymphocyte ratio; peritoneal dialysis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
ROC curve for the logistic regression model predicting 18-month composite outcome (death or transfer to hemodialysis) among peritoneal dialysis patients (AUC = 0.913, p < 0.001).
Figure 2
Figure 2
ROC curve for the logistic regression model predicting 18-month mortality among peritoneal dialysis patients (AUC = 0.863, p < 0.001).
See this image and copyright information in PMC

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