P1592HYPOCHLOREMIA AND INFLAMMATION: RELATIONSHIP BETWEEN SERUM CHLORIDE LEVELS AND NEUTROPHIL-TO-LYMPHOCYTE RATIO IN INCIDENT CHRONIC HEMODIALYSIS PATIENTS

Abstract Background and Aims Recently the role of chloride in patients with heart failure has been reevaluated. Some studies have linked it to higher mortality in these patients, being more important, even, than sodium. On the other hand, some authors have found a higher mortality in patients with low chloride levels and sepsis. The underlying mechanisms in both cases are unknown. Some authors attribute it to concomitance with metabolic alkalosis, however, this is not a reason that fully explains these findings. Neutrophil-to-Lymphocyte Ratio (NLR) is an emerging marker of inflammation comparable to established ones such as C-reactive protein, ferritin, etc. It is also a good biomarker of mortality in certain populations such as cancer, cardiovascular and renal. Patients with chronic kidney disease on hemodialysis have high cardiovascular comorbidity and a high rate of inflammation. However, there are no studies that correlate chloride levels to inflammation markers, such as NLR, in this population. Therefore, the aim of our study was to determine if there is a relationship between chloride and NLR in our population of patients on chronic hemodialysis. Method Restrospective cohort study. We analyzed the values of chloride and NLR of 396 incident patients on hemodialysis over a period of 3 years (between 2016 and 2019). The patients were divided into three groups, depending on the levels of chloride (tertiles): (1: <100, 2: 100.1-103, 3> 103.1 mEq / l). In each group the average of NLR was calculated. Results The mean age in our sample was 64.73 ± 0.57 years, 39.7% were women (N = 157). The average of NLR was 3.84 ± 2.65 and chloride was 101.03 ± 3.91. We found that patients in the lower chloride level tertile were associated with a higher NLR levels (p <0.012). (Figure 1) Conclusion Incident hemodialysis patients with lower chloride levels had higher NLR values. These findings suggest a greater tendency to inflammation in these patients.