{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:18:05Z","timestamp":1788171485891,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronic systemic inflammation and malnutrition drive adverse outcomes in maintenance hemodialysis (HD) patients. This study investigated the prognostic utility of four accessible inflammatory indices\u2014systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), atherogenic index of plasma (AIP), and advanced lung cancer inflammation index (ALI)\u2014in predicting survival. Materials and Methods: This retrospective cohort study evaluated electronic health records of 222 incident HD patients in Turkey (2014\u20132021), followed through December 2024. Baseline biomarkers were calculated prior to HD initiation. Survival outcomes were assessed using Kaplan\u2013Meier curves, and independent predictors of all-cause mortality were determined via multivariable Cox proportional hazards regression models. Results: During a median follow-up of 24.9 months, 106 patients (47.7%) died. Non-survivors presented with significantly higher median SII, NLR, and AIP, and markedly lower ALI than survivors (all p &lt; 0.001). Multivariable analysis revealed that elevated SII (HR: 1.035, 95% CI: 1.020\u20131.050; p &lt; 0.001) and NLR (HR: 1.081, 95% CI: 1.042\u20131.122; p &lt; 0.001) were risk factors for mortality. In contrast, higher ALI demonstrated a significant protective effect on survival (HR: 0.975, 95% CI: 0.953\u20130.998; p = 0.036). Kaplan\u2013Meier analyses confirmed superior overall survival in patients with lower SII, NLR, AIP, and higher ALI. Conclusions: SII, NLR, AIP, and ALI are practical, cost-effective biomarkers for mortality risk stratification in HD patients. ALI, integrating both nutritional and inflammatory dimensions, demonstrates particularly robust prognostic value for predicting survival.<\/jats:p>","DOI":"10.3390\/medicina62091670","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:21:19Z","timestamp":1788168079000},"page":"1670","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Value of Inflammatory Indices and the Advanced Lung Cancer Inflammation Index (ALI) for Survival Outcomes in Hemodialysis Patients"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4082-6320","authenticated-orcid":false,"given":"Demet","family":"Yavuz","sequence":"first","affiliation":[{"name":"Department of Nephrology, Samsun City Hospital, 55080 Samsun, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Mehmet Derya","family":"Demirag","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Samsun City Hospital, 55080 Samsun, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1969-6912","authenticated-orcid":false,"given":"Enis","family":"Akca","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Samsun City Hospital, 55080 Samsun, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4423-6544","authenticated-orcid":false,"given":"Muhammed Ali","family":"Atasever","sequence":"additional","affiliation":[{"name":"Department of Oncology, Ministry of Health Basaksehir Cam and Sakura City Hospital, Basaksehir, 34480 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Mehmet Omer","family":"Bostanci","sequence":"additional","affiliation":[{"name":"Department of Physiology, Faculty of Medicine, Hitit University, 19040 Corum, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Nihal","family":"Aydemir","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Samsun City Hospital, 55080 Samsun, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.kint.2019.11.010","article-title":"Epidemiology Research to Foster Improvement in Chronic Kidney Disease Care","volume":"97","author":"Luo","year":"2020","journal-title":"Kidney Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2512405","DOI":"10.1080\/0886022X.2025.2512405","article-title":"Malnutrition-Inflammation-Fluid Overload Complex Syndrome and All-Cause Mortality in Patients Undergoing Hemodialysis","volume":"47","author":"Tian","year":"2025","journal-title":"Ren. 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