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Impact of immune marker-based microinflammation on dialysis efficacy in diabetic nephropathy patients: Development of an early prediction model 

Meiyang Zhou, Haole Huang, and Canxin Zhou

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Volume 105 (2026) p. 308 - 317

Abstract

Clinical Nephrology, Vol. 105 – No. 5/2026 (308-317)

Impact of immune marker-based microinflammation on dialysis efficacy in diabetic nephropathy patients: Development of an early prediction model 

Meiyang Zhou, Haole Huang, and Canxin Zhou

Department of Nephrology, The Affiliated People’s Hospital, Ningbo University, Ningbo, Zhejiang, China
Background: Peritoneal dialysis (PD) is widely used for treating end-stage renal disease (ESRD) in diabetic nephropathy patients. Suboptimal dialysis outcomes are often linked to chronic microinflammation, yet predictive models integrating immune markers remain limited.
Materials and methods: In this prospective cohort study, 236 diabetic nephropathy patients undergoing PD were categorized into high-inflammation (HI) and microinflammation (MI) groups based on serum levels of CRP, IL-6, and TNF-α. Clinical and biochemical data – including Kt/V, infection rates, and survival – were collected. Logistic regression was applied to identify predictors of poor dialysis outcomes and construct a predictive model.
Results: The HI group showed significantly lower dialysis efficiency (Kt/V < 1.5), increased peritonitis and catheter infections, and reduced survival. Elevated CRP, IL-6, and TNF-α levels were observed alongside higher creatinine, urea nitrogen, fasting glucose, lipids, and notable electrolyte and acid-base imbalances. Logistic regression identified CRP, IL-6, TNF-α, Kt/V, infection rates, and selected biochemical markers as independent predictors of poor outcomes. The resulting predictive model yielded an AUC of 0.87, demonstrating strong discriminative power.
Conclusion: Microinflammation is a key determinant of dialysis efficacy in diabetic nephropathy patients receiving PD. The proposed model, based on inflammatory and dialysis-related parameters, offers a promising approach for early risk stratification and personalized treatment. Further validation may enhance long-term management and survival outcomes in this population.Correspondence to:
Zhou Meiyang, MM
Department of Nephrology
The Affiliated People’s Hospital of Ningbo University
Ningbo, Zhejiang, 315040, China
Email: [email protected]

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