Objective: This study aims to identify the association between pan-immune-inflammation value (PIV, calculated as neutrophil count × platelet count × monocyte count/lymphocyte count) and the risk of the first episode of peritoneal dialysis-associated peritonitis (PDAP) in patients undergoing peritoneal dialysis (PD). Methods: This retrospective cohort study included 375 PD patients treated at the Peritoneal Dialysis Center of XX Hospital between January 2018 and December 2024. Patients were categorized into high and low PIV groups based on the optimal cutoff value determined by Harrell’s C-index. Kaplan–Meier survival curves, Cox proportional hazards models, and Fine–Gray competing risk models were used to assess the association between PIV and the first episode of PDAP. The predictive performance of PIV was compared with other inflammatory markers using receiver operating characteristic (ROC) analysis. Results: During the follow-up period, 97 patients experienced a first episode of PDAP. Kaplan–Meier analysis showed that the cumulative incidence of first-episode PDAP was significantly higher in the high PIV group (log-rank test, p < 0.001). In the multivariable Cox regression models, high PIV remained independently associated with an increased risk of the first episode of PDAP. The Fine–Gray competing risk model showed that significant differences still existed between the high and low PIV groups in the presence of other competitive events (p < 0.001). ROC analysis demonstrated that the area under the curve (AUC) of PIV (0.820) was comparable to that of the systemic immune-inflammation index (SII, 0.812, p = 0.552), but significantly superior to C-reactive protein (CRP) (0.683), monocyte-to-lymphocyte ratio (MLR) (0.719), neutrophil-to-lymphocyte ratio (NLR) (0.762), and platelet-to-lymphocyte ratio (PLR) (0.749) (all p < 0.01). Conclusion: PIV is an independent predictor of the first episode of PDAP among patients undergoing PD and may serve as a valuable marker for early risk stratification in this population.
He et al. (Wed,) studied this question.