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Journal of Medicine and Palliative Care

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Original Article
Association between leukocyte-based inflammatory indices and bone mineral density in hemodialysis patients
Abstract
Aims: Osteoporosis and osteopenia are common among hemodialysis (HD) patients, yet current methods for risk stratification remain limited. This study aimed to investigate the relationship between leukocyte-based inflammatory indices and osteoporosis and osteopenia in HD patients and to assess their diagnostic performance in differentiating these conditions.
Methods: A retrospective analysis was conducted on 168 HD patients classified into normal bone mineral density (BMD) (n=43), osteopenia (n=70), and osteoporosis (n=55) based on T-scores by dual-energy X-ray absorptiometry measurements. The leukocyte-based inflammatory indices were calculated as follows: Platelet to lymphocyte ratio (PLR)=platelet count/lymphocyte count ratio; neutrophil o lymphocyte ratio (NLR)=neutrophil count/ lymphocyte count ratio; systemic immune inflammation index (SII)=platelet count×neutrophil count / lymphocyte count ratio, and systemic inflammation response index (SIRI)=neutrophil count×monocyte count/ lymphocyte count ratio.
Results: Osteopenia and osteoporosis were identified in 41.7% and 32.7% of patients, respectively. Patients with osteoporosis exhibited higher neutrophil and monocyte counts and lower lymphocyte counts (p<0.001). All inflammatory indices were higher in osteoporosis group compared to other group. Also, these indices were higher in osteopenia group compared to normal BMD group. SIRI showed the strongest discriminative power for differentiating osteopenia from normal BMD (AUC=0.84; sensitivity=81.4%; specificity=79.2%, p<0.001) and osteoporosis from osteopenia (AUC=0.86; sensitivity=82.5%; specificity=78.6%; p<0.001).
Conclusion: Leukocyte-based inflammatory indices, particularly SIRI, are significantly associated with reduced BMD in HD patients and may serve as accessible biomarkers for identifying those at heightened risk of osteopenia and osteoporosis.

Keywords : Bone mineral density, hemodialysis, osteoporosis, systemic inflammation

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Article available in :
Volume 6, Issue 2, 2025
Page : 131-137
https://doi.org/10.47582/jompac.1642972
Article Information
Received : 19 Şub 2025
Accepted : 17 Mar 2025
Published : 23 Mar 2025
Corresponding Author :

Javid Mohammadzadeh Azarabadi: Department of Orthopedics and Traumatology, Faculty of Medicine, Başkent University, Konya, Turkiye

dr_jma_md@yahoo.com
Citation : Azarabadi JM, Shalalfa N. Association between leukocyte-based inflammatory indices and bone mineral density in hemodialysis patients. J Med Palliat Care. 2025;6(2):131-137.

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