Contribution of platelets indices in the development of contrast-induced nephropathy

Abstract

Contrast-induced nephropathy (CIN) accounts for 10% of hospital-acquired renal failure, causes a prolonged in-hospital stay and represents a powerful predictor of poor clinical outcome. The underlying mechanism of the CIN development remains unclear and seems to be multifactorial. The potential link between platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW) with CIN is unknown. Herein, we aimed to investigate the correlation between MPV and PDW levels with the development of CIN. The incidence of CIN (20.5%) was prospectively evaluated in 430 patients with diagnosis of acute coronary syndrome. Initial creatinine (1.13 ± 0.25 vs. 1.05 ± 0.27 mg/dl, P = 0.01) and PDW (40.1 ± 20.2 vs. 34.5 ± 19.9%, P = 0.02) levels and the total volume of contrast media used (121 ± 61 vs. 94 ± 42 ml, P = 0.01) were higher in patients who developed CIN. MPV was similar between the two groups (P = 0.80). In a univariate regression analysis, age, increased creatinine, uric acid, phosphate, PDW levels and higher total volume of contrast media used were significantly correlated with CIN incidence. However, in a multivariate analysis, only total volume of CM used [odds ratio (OR) 1.011, 95% confidence interval (CI) 1.006-1.016; P = 0.01], increased age (OR 1.026, 95% CI 1.00-1.052; P = 0.05) and increased PDW levels (OR 1.009, 95% CI 1.00-1.022; P = 0.04) remained as the independent predictors of CIN. Among platelet indices, PDW, but not MPV, was associated with CIN development. The clinical significance of such link remains unclear, but may indicate involvement of platelet activation in CIN pathogenesis.

Some Full Blood Count Parameters among Hypertensive Patients Attending Specialist Hospital, Sokoto, Nigeria

“…We observed that the White Cell Count (WBC) was significantly lower among the hypertensive subjects compared to non-hypertensive controls. Our finding is consistent with a previous report which showed a lower mean value of WBC count in hypertensive individuals when compared to apparently healthy normotensive subjects [44] [45]. In two community studies that adjusted for such coronary risk factors, the WBC count was no longer associated with elevated coronary risk.…”

Association of monocyte to HDL cholesterol level with contrast induced nephropathy in STEMI patients treated with primary PCI

“…Advanced age, baseline renal function, DM and the amount of CM used are accepted as the major risk factors for CIN [13,31]. In addition, many new prognostic parameters such as CV/eGFR, red cell distribution width, and mean platelet volume have been defined for the prediction of CIN [14][15][16]. In this study, we have shown that patients with elevated MHR levels have higher risk for CIN after primary PCI.…”

“…Recently, the prognostic importance of many clinical and laboratory parameters have also been shown [14][15][16][17]. Monocyte to HDL-cholesterol ratio (MHR) is a novel laboratory parameter which is correlated with inflammation and has a prognostic value in patients with renal and cardiovascular diseases [18][19][20][21].…”

Association of contrast-induced nephropathy with bare metal stent restenosis in STEMI patients treated with primary PCI

“…13 Several predictors of CIN have been defined and in our study, we have found that systolic blood pressure and total volume of CM used are correlated with risk of CIN. 26,27 In STEMI, early coronary intervention is important for myocardial salvage and in most of the cases admission laboratory parameters including creatinine levels could not be evaluated before CAG. As restoration of the coronary flow is vital, higher volumes of CM are usually needed compared to diagnostic and elective interventional procedures.…”