Elif Azize Özşahin DELİBAŞ, Yunus Emre KUYUCU
Turkish Journal of Nephrology - 2026;35(4):319-326
Background: Chronic kidney disease (CKD) is often accompanied by systemic inflammation and malnutrition. This study aimed to evaluate whether hematological inflammatory markers-the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)-are associated with nutritional status, as determined by the prognostic nutritional index (PNI) and to explore their potential predictive value in identifying patients at risk of malnutrition. Methods: A total of 267 adult patients admitted to the nephrology outpatient clinic were included in this cross-sectional study. Malnutrition was defined using a PNI cut-off value of <42.3. Inflammatory markers were calculated from complete blood count parameters. Statistical analyses included group comparisons and correlation analyses between nutritional and inflammatory indices. Results: Albumin levels were higher in females than males (P = .031), while other parameters did not differ by sex. No significant differences were observed among age groups. Anemic patients had higher white blood cell, NLR, PLR, and SII levels and lower albumin and PNI values compared with non-anemic patients (all P < .001). In multivariable linear regression, NLR and PLR were negatively associated with PNI, whereas SII showed a positive association (all P < .001). Logistic regression analysis showed that PLR was significantly associated with malnutrition (odds ratio (OR) = 1.015, P = .003). Receiver operating characteristic analysis demonstrated the highest discriminative ability for PLR (area under the curve (AUC) = 0.842), followed by NLR (AUC = 0.789) and SII (AUC = 0.717). Conclusion: Inflammatory indices, particularly PLR and NLR, are significantly associated with nutritional status in CKD patients. These simple hematological markers may help identify patients at risk of malnutrition in routine clinical practice.
