Transforming Growth Factor-β (TGF-β) Levels and Neutrophil-to-Lymphocyte (NLR) and Platelet-to-Lymphocyte Ratios (PLR) in Patients With Chronic Kidney Disease (CKD) Undergoing Maintenance Hemodialysis

Aim: This study investigated inflammatory markers involved in the pathogenesis of atherosclerosis in patients with Chronic Kidney Disease (CKD) undergoing maintenance hemodialysis (HD). Methods: This cross-sectional study included 144 patients with CKD (65 females, 79 males) undergoing maintenance HD and 23 healthy controls (12 females, 11 males). Serum concentrations of Transforming Growth Factor-β (TGF-β), C-reactive protein (CRP), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR) were determined. Group comparisons were performed, and associations were examined using crude and multivariable-adjusted logistic regression models. Results: TGF-β, NLR, and PLR levels were significantly higher in HD patients than in controls (p < 0.001, p < 0.001, and p = 0.041, respectively), along with elevated CRP (p < 0.001). ROC analysis showed good diagnostic performance for TGF-β (AUC 0.812) and NLR (AUC 0.863), but weaker for PLR (AUC 0.633). In the crude logistic regression analysis, all three markers demonstrated significant associations with end-stage renal disease (ESRD). After adjustment for age, sex, hypertension, cardiovascular disease (CVD), malignancy, and inflammatory diseases, TGF-β remained significantly associated with ESRD (OR: 1.026; 95% CI: 1.003–1.050; p = 0.027). Similarly, after adjustment for age, sex, hypertension, CVD, diabetes mellitus (DM), malignancy, and inflammatory diseases, NLR was independently associated with ESRD (OR: 8.196; 95% CI: 1.554–43.227; p = 0.013). Finally, following adjustment for age, sex, hypertension, CVD, DM, and malignancy, PLR also showed a significant association with ESRD (OR: 1.019; 95% CI: 1.002–1.037; p = 0.033). Conclusion: Inflammatory markers, including TGF-β, NLR, and PLR, are significantly elevated in patients with CKD receiving maintenance HD compared with healthy individuals. These markers are associated with HD even after adjusting for significant covariates.