Platelet Distribution Width and Mortality in Hemodialysis Patients

Abstract

Objectives. The association between platelet distribution width (PDW) and mortality in hemodialysis (HD) patients has received little attention. Methods. We retrospectively enrolled HD patients in a single center from January 1, 2008, to December 30, 2011. The primary and secondary endpoints were all-cause and cardiovascular mortality, respectively. The association between PDW and mortality was estimated by Cox regression model. Results. Of 496 patients, the mean age was 52.5 ± 16.6 years, and the Charlson comorbidity index was 4.39 ± 1.71. During the follow-up period of 48.8 ± 6.7 months, 145 patients (29.2%) died, including 74 (14.9%) cardiovascular deaths. 258 (52.0%) with PDW < 16.31% were in the low group and 238 (48.0%) in those with PDW ≥ 16.31% according to cut-off for all-cause mortality by receiving-operator characteristics. After adjusting for confounding factors, high PDW values were independently associated with higher risk of all-cause (hazards ratio (HR) = 1.49, 95% confidence interval (CI) 1.15–6.82) and cardiovascular deaths (HR = 2.26, 95% CI 1.44–3.63) in HD patients. When comparing with quartile 1 of PDW, quartile 4 of PDW was independently associated with a higher risk of all-cause (HR = 1.59, 95% CI 1.18–5.30) and cardiovascular deaths (HR = 2.71, 95% CI 1.49–3.76) in HD patients. Conclusions. Baseline PDW was independently associated with all-cause and cardiovascular mortality in HD patients.

The relationship of platelet distribution width with all-cause and cardiovascular mortality in peritoneal dialysis patients

“…PDW is a specific marker reflecting platelet activity [ 6 ]. It was shown that a large PDW value indicated a large reticulated platelet volume and high metabolic activity [ 5 ]. A high platelet activity means that the platelets can strongly promote inflammation and coagulation that are closely related to CVD [ 13 ].…”

“…A retrospective cohort study of 1557 PD patients revealed that PDW > 13.2 fL was associated with the incidence of new-onset CVD in PD patients [ 12 ]. In one study of HD patients, it was shown that PDW ≥ 16.31% was independently associated with a high risk of all-cause and cardiovascular deaths [ 5 ]. Yu et al.…”

“…PDW is also a special marker of platelet activity, and a high PDW value indicates platelet activation [ 4–6 ]. A cohort study of patients on maintenance hemodialysis (HD) has revealed that PDW is independently associated with all-cause and cardiovascular mortality [ 5 ]. However, the relationship of elevated PDW with all-cause and cardiovascular mortality in PD patients has not been adequately explored [ 7 ].…”

The Effects of Platelet Indices on Early Mechanical Complications of Peritoneal Dialysis

“…Studies have been conducted with PDW in many clinical conditions related to the kidney. Ruijan et al showed that PDW is associated with cardiovascular and all-cause mortality in patients treated with hemodialysis [24]. In a study of Yu et al, PDW was shown to be a marker for predicting lupus nephritis [25].…”

High platelet distribution width is an independent risk factor of postoperative pneumonia in patients with type A acute aortic dissection

“…In a predictive model for AAAD, Wang et.al ( 19 ) displayed that PDW was an independent factor in predicting in-hospital death (hazard ratio: 3.755, 95% CI: 1.436–9.815, P < 0.001). A retrospective cohort found that high PDW values (≥16.31%) were independently associated with higher risk of all-cause (hazard ratio: 1.49, 95% CI: 1.15–6.82) and cardiovascular deaths (hazard ratio: 2.26, 95% CI: 1.44–3.63) in hemodialysis patients ( 20 ). Regarding to acute myocardial infarction treated with primary percutaneous coronary intervention, Rechciński et al ( 6 ) observed higher PDW values (≥16 fL) correlated with a higher mortality rate when compared with PDW < 16 fL (17.4 vs. 6.3%, P = 0.001) in a sample of 538 patients.…”