Associations of platelet indices with proteinuria and chronic kidney disease

Abstract

Objectives Platelet (PLT) indices are predictive in many diseases and conditions. The relationships of these indices with proteinuria and progression of renal disease are not well known. This study aimed to assess PLT indices in patients with primary glomerular nephrotic range proteinuria (PGNRP), with and without chronic kidney disease (CKD), and to compare these indices with those of healthy individuals (His). Methods This cross-sectional study was performed from January 2015 to May 2015. HIs (n = 57) and patients with PGNRP (n = 41) were enrolled. PLT indices and blood biochemistry parameters were compared between HIs and patients with PGNRP, as well as between subgroups of patients with PGNRP who had CKD (n = 23) and those who did not have CKD (n = 18). Results There were no statistically significant differences in any PLT indices (i.e., platelet number, mean platelet volume, plateletcrit, and platelet distribution width) between HIs and patients with PGNRP, or between the subgroups of patients with PGNRP. However, patients with PGNRP who had CKD exhibited higher median C-reactive protein and mean albumin levels, compared with patients who did not have CKD. Conclusions Pathological processes in proteinuria and CKD are not associated with PLT indices.

Platelet Function in CKD: A Systematic Review and Meta-Analysis

“…Approximately 70% of the studies reported that the platelet count of patients with CKD was comparable to that of healthy controls, 25 –38 although 25% of the studies observed a reduction 20 –24 and one study reported an increased platelet count. 39 Almost half of the studies reported that mean platelet volume of CKD platelets was not different to that of healthy platelets, 29,36,37,41 whereas others either observed a decreased 22,40 or an increased mean platelet volume. 24,38,42 Furthermore, platelet expression levels of glycoprotein Ib (GPIb) (vWF receptor), GPIIb, GPIIIa (GPIIb/GPIIIa: fibrinogen receptor), α 2 -adrenergic receptor, and P-selectin were reported to be comparable to those of healthy controls.…”

“…Approximately 70% of the studies reported that the platelet count of patients with CKD was comparable to that of healthy controls, [25][26][27][28][29][30][31][32][33][34][35][36][37][38] although 25% of the studies observed a reduction [20][21][22][23][24] and one study reported an increased platelet count. 39 Almost half of the studies reported that mean platelet volume of CKD platelets was not different to that of healthy platelets, 29,36,37,41 whereas others either observed a decreased 22,40 or an increased mean platelet volume. 24,38,42 Furthermore, platelet expression levels of glycoprotein Ib (GPIb) (vWF receptor), GPIIb, GPIIIa (GPIIb/GPIIIa: fibrinogen receptor), a 2 -adrenergic receptor, and P-selectin were reported to be comparable to those of healthy controls.…”

Updates on New Therapies for Patients with CKD

“…In addition, resting platelets can be activated with stimulus in CKD milieu. 21 , 31 , 32 Furthermore, patients with CKD with albuminuria demonstrate stimulated platelets with increased aggregation via surface receptors. 33 Although CKD milieu can activate platelets in the circulation, data are limited regarding dynamic modulation of platelet-mediated leukocytic changes that drive inflammation in CKD milieu.…”