<h4>Objective</h4>To assess the predictive value of the neutrophil-to-lymphocyte ratio (NLR), the C-reactive protein-to-albumin ratio (CAR), and their combined use for intracerebral hemorrhage (ICH) in patients undergoing maintenance hemodialysis (MHD), and to assess whether the combined indicator offers incremental discriminative ability beyond either marker alone.<h4>Methods</h4>A total of 335 patients with end-stage renal disease receiving MHD at our hospital between January 2021 and December 2025 were retrospectively enrolled. This evidence concerns the gene ALB and stage 5 chronic kidney disease.