Objective To investigate the value of triglyceride (TG) / high-density lipoprotein cholesterol (HDL-C) combined with C-reactive protein (CRP) / albumin (Alb) in predicting the risk of death among patients on peritoneal dialysis.Methods The clinical data of 197 patients with chronic renal insufficiency undergoing peritoneal dialysis in the Second People's Hospital of Jingdezhen City and the Third People's Hospital of Jingdezhen City from January 2017 to December 2022 were retrospectively analyzed. According to the death of patients on peritoneal dialysis, they were divided into the death group and the survival group, and the clinical data of the two groups were compared. Multivariable stepwise Cox regression was used to analyze the risk factors for death among patients on peritoneal dialysis. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was applied to evaluate the predictive value of TG/HDL-C, CRP/Alb and their combination for death among patients on peritoneal dialysis.Results Forty-six of 197 patients on peritoneal dialysis died, with the mortality rate being 23.35%. The age, proportions of coronary heart disease, diabetes mellitus, hypertension, and statin use, platelet count, white blood cell count, neutrophil count, neutrophil to lymphocyte ratio (NLR), TG/HDL-C, and CRP/Alb in death group were higher than those in the survival group (P < 0.05). The lymphocyte count and the level of total bilirubin in the death group were lower than those in the survival group (P < 0.05). Multivariable stepwise Cox regression revealed that advanced age [O^R = 3.080 (95% CI: 1.354, 7.007)], high NLR [O^R = 4.175 (95% CI: 1.835, 9.496) ], high TG/HDL-C [O^R = 2.735 (95% CI: 1.202, 6.221)] and high CRP/Alb [O^R = 3.168 (95% CI: 1.393, 7.206) ] were risk factors for death in patients on peritoneal dialysis (P < 0.05). ROC curve analysis showed that the sensitivities of TG/HDL-C, CRP/Alb and their combination in predicting the death of patients on peritoneal dialysis were 86.96% (95% CI: 0.564，0.892), 84.78% (95% CI: 0.541，0.873), and 86.96% (95% CI: 0.568，0.893), with the specificities being 87.42% (95% CI: 0.572，0.898), 82.12% (95% CI: 0.522，0.872), and 96.03% (95% CI: 0.679，0.982), and the AUCs being 0.863 (95% CI: 0.785, 0.918), 0.796 (95% CI: 0.716, 0.867) and 0.930 (95% CI: 0.870, 0.968), respectively (P < 0.05).Conclusions Patients on peritoneal dialysis are at a high risk for death, and most of them die due to cardiovascular events. TG/HDL-C and CRP/Alb can be used to predict the risk for death in patients on peritoneal dialysis, and the combination of the two yields a higher predictive value.