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Background <p>The C-reactive protein-albumin-lymphocyte (CALLY) index is an emerging integrated inflammatory biomarker that reflects a patient’s inflammatory, nutritional, and immune status; its application in peritoneal dialysis (PD) patients remains unexplored.</p> Methods <p>This retrospective cohort study enrolled 955 PD patients and divided them into four groups according to the CALLY quartiles. Kaplan–Meier analysis assessed differences in survival rates. Cox regression models and time-dependent receiver operating characteristic (ROC) curves evaluated the impact of CALLY and other indices on all-cause mortality. Decision curve analysis (DCA) estimated predictive performance and clinical utility.</p> Results <p>The highest CALLY quartile group exhibited a significantly lower risk of all-cause mortality compared to the lowest quartile group (HR: 0.26, 95%CI: 0.12–0.57, <i>p</i> = 0.001). ROC analysis demonstrated that CALLY achieved higher predictive accuracy, with an area under the curve (AUC) of 0.753 (95%CI: 0.686–0.821), compared with C-reactive protein to lymphocyte ratio (CLR) (AUC: 0.730, 95%CI: 0.656–0.803) and C-reactive protein (AUC: 0.676, 95%CI: 0.598–0.755). Adding CALLY to a conventional risk model improved discrimination (Harrell’s C-index: 0.824 vs. 0.807, <i>p</i> = 0.014), demonstrating its potential incremental value for mortality prediction in PD patients.</p> Conclusion <p>The CALLY index can independently predict all-cause mortality in PD patients, and may have incremental value beyond traditional risk factors, with potential clinical decision-making value.</p>

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Predictive value of the C-reactive protein-albumin-lymphocyte (CALLY) index for all-cause mortality in peritoneal dialysis patients

  • 期刊论文

  • 发表日期：

    2026年3月24日

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  • Xiaohui Fu,
  • Xiaoyu Guo,
  • Zeyi Jiang,
  • Min Liu,
  • Yinghong Liu

摘要

Background

The C-reactive protein-albumin-lymphocyte (CALLY) index is an emerging integrated inflammatory biomarker that reflects a patient’s inflammatory, nutritional, and immune status; its application in peritoneal dialysis (PD) patients remains unexplored.

Methods

This retrospective cohort study enrolled 955 PD patients and divided them into four groups according to the CALLY quartiles. Kaplan–Meier analysis assessed differences in survival rates. Cox regression models and time-dependent receiver operating characteristic (ROC) curves evaluated the impact of CALLY and other indices on all-cause mortality. Decision curve analysis (DCA) estimated predictive performance and clinical utility.

Results

The highest CALLY quartile group exhibited a significantly lower risk of all-cause mortality compared to the lowest quartile group (HR: 0.26, 95%CI: 0.12–0.57, p = 0.001). ROC analysis demonstrated that CALLY achieved higher predictive accuracy, with an area under the curve (AUC) of 0.753 (95%CI: 0.686–0.821), compared with C-reactive protein to lymphocyte ratio (CLR) (AUC: 0.730, 95%CI: 0.656–0.803) and C-reactive protein (AUC: 0.676, 95%CI: 0.598–0.755). Adding CALLY to a conventional risk model improved discrimination (Harrell’s C-index: 0.824 vs. 0.807, p = 0.014), demonstrating its potential incremental value for mortality prediction in PD patients.

Conclusion

The CALLY index can independently predict all-cause mortality in PD patients, and may have incremental value beyond traditional risk factors, with potential clinical decision-making value.