Systemic inflammatory response index as an independent predictor of all-cause mortality in patients receiving maintenance hemodialysis: a retrospective cohort study

PurposeChronic kidney disease (CKD) represents a major global public health burden, with affected individuals facing substantially elevated risks of morbidity, mortality, and healthcare resource utilization. In this context, the present study was undertaken to evaluate the prognostic value of the systemic inflammatory response index (SIRI) in patients undergoing maintenance hemodialysis.Patients and methodsA total of 534 maintenance hemodialysis patients were included in the study. The median follow-up duration was 26.0 months. The primary endpoint of this study was all-cause mortality. We compared a comprehensive panel of laboratory parameters between the survival and non-survival groups, including metabolic markers (serum triglycerides, total cholesterol, uric acid, calcium, sodium, and potassium), renal function indices (serum creatinine and blood urea nitrogen), hematological parameters (hemoglobin, hematocrit, white blood cell, platelet, neutrophil, lymphocyte, and monocyte counts), and inflammatory markers (albumin and C-reactive protein). Furthermore, we derived five composite inflammatory indices from the complete blood count: NLR, PLR, MLR, SIRI, and SII.ResultsDuring a median follow-up period, 105 of 534 patients (19.7%) died. Compared with survivors, non-survivors were significantly older and exhibited higher levels of inflammatory markers, including CRP and SIRI, along with lower hemoglobin and albumin levels. In multivariate analysis, age, serum potassium, hemoglobin, and SIRI (OR: 1.072, 95% CI: 1.009–1.139, p = 0.025) emerged as independent predictors of all-cause mortality. ROC analysis demonstrated that SIRI had acceptable discriminative ability (AUC: 0.724), with an optimal cut-off value of 2.3, and patients with SIRI ≥2.3 had significantly shorter survival than those with lower values (log-rank p < 0.001).ConclusionSIRI demonstrated clinical utility as a novel, readily available biomarker for predicting all-cause mortality in patients undergoing maintenance hemodialysis.