Preprocedural neutrophil-to-albumin ratio predicts survival in patients undergoing tunneled hemodialysis catheter

Aim This study aimed to evaluate the impact of preprocedural neutrophil-to-albumin ratio (NAR) on survival among patients undergoing tunneled hemodialysis catheter (THC) placement.Methods We retrospectively reviewed 60 consecutive patients who underwent right-internal-jugular THC placement between July 2021 and October 2023. Demographics, laboratory variables and survival were collected. NAR and neutrophil-percentage-to-albumin ratio (NPAR) were calculated. Cox regression and Kaplan – Meier analyses explored associations with mortality; receiver-operating-characteristic (ROC) curves defined optimal cutoffs.Results Mean age was 70 ± 12 years; 24 patients (40%) died, yielding one-year survival of 62.5%. On multivariate Cox regression analysis, after adjustment for all covariates, higher NAR remained an independent predictor of mortality (p <0.001), together with older age and coronary artery disease. The ROC-derived NAR threshold of 175.4 produced an AUC of 0.813 (95% CI: 0.683–0.942). Patients with NAR >175.4 had markedly lower one-year survival than those below the threshold (30.2% vs 88.2%, p <0.001). Catheter patency at one year was 84.8%.Conclusion Among patients receiving a tunneled hemodialysis catheter, elevated preprocedural NAR levels were associated with increased mortality. NAR, which is an easily and routinely measurable parameter, may serve as a prognostic biomarker in this patient population.