The association between platelet indices and cardiovascular events in chronic kidney disease patients without dialysis

Yu, Zhikai; Xiong, Jiachuan; Yang, Kang; Huang, Yunjian; He, Ting; Yu, Yanlin; Zhao, Jinghong

doi:10.1007/s11255-020-02696-4

Cited by 10 publications

(11 citation statements)

References 36 publications

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“…We also observed a reduction in mean platelet count and higher mean platelet volume that parallels other studies of AKI (27), CKD (28,29), and chronic dialysis (30). Although a lower mean platelet count could arise from an increase in platelet consumption/clearance or a reduction in production from bone marrow/half-life when it occurs with a higher mean platelet volume, the most likely explanation is that CKD is associated with a high platelet turnover and generation of younger platelets with larger volumes.…”

Section: Discussionsupporting

confidence: 90%

Platelet-Dependent Inflammatory Dysregulation in Patients with Stages 4 or 5 Chronic Kidney Disease: A Mechanistic Clinical Study

et al. 2022

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Background. Chronic kidney disease (CKD) is characterized by dysregulated inflammation that worsens with CKD severity. The role of platelets in modulating inflammation in stages 4 or 5 CKD remains unexplored. We investigated whether there are changes in platelet-derived thromboinflammatory markers in CKD with dual antiplatelet therapy (DAPT- aspirin 81 mg/d plus P2Y12 inhibitor). Methods. In a mechanistic clinical trial, we compared platelet activation markers, circulating platelet-leukocyte aggregates, leukocyte composition, and plasma cytokine profile of non-CKD controls (n=26) and CKD outpatients (n=48) with glomerular filtration rate (GFR expressed in ml/min/1.73m2) <30 on 2 weeks of DAPT. Results. Patients with CKD demonstrated reduced mean platelet count, elevated mean platelet volume, reduced platelet-leukocyte aggregates, reduced platelet-bound monocytes, higher total non-classical monocytes in the circulation, and higher levels of IL-1RA, VEGF, and fractalkine. There were no differences in platelet activation markers between CKD and controls. Although DAPT reduced platelet aggregation, it had multifaceted effects on thromboinflammatory markers in CKD, including a reduction in TNFα levels among a CKD subgroup younger than 55 years, diabetics, had GFR ≥15 or albuminuria ≥1000 mg/g; and, no change in a number of other cytokines. Correlation analysis and minimum spanning trees plot of 45-cytokine panel showed platelet-derived CD40L showed a large reduction in weight factor after DAPT in CKD. Additionally, platelet-derived IL-1β and PDGF were tightly correlated with other cytokines with IL-1β as the hub cytokine. Conclusion. Attenuated interactions between platelets and leukocytes in the CKD state coincided with no change in platelet activation status, an altered differentiation state of monocytes, and heightened inflammatory markers. Platelet derived cytokines were one of the central cytokines in CKD. DAPT had multifaceted effects on thromboinflammation suggesting that there are platelet-dependent and platelet-independent inflammation in stages 4 or 5 CKD.

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Section: Discussionsupporting

confidence: 90%

Platelet-Dependent Inflammatory Dysregulation in Patients with Stages 4 or 5 Chronic Kidney Disease: A Mechanistic Clinical Study

et al. 2022

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“…It was also discovered that patients with CVDs had higher mean platelet volumes than those without CVDs in CKD [ 57 ]. Our group also reported that platelet counts, plateletcrit, and platelet distribution width were associated with CVD events in CKD patients without dialysis [ 58 ]. The changes in platelet indices in CKD patients indicate the vital role of platelets in CKD-related CVDs.…”

Section: Involvement Of Activated Platelets In Cardiovascular Complic...mentioning

confidence: 99%

Activated Platelets, the Booster of Chronic Kidney Disease and Cardiovascular Complications

Gong¹,

Wang²,

Xiong³

et al. 2022

Kidney Dis

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<b><i>Background:</i></b> Chronic kidney disease (CKD) has become a global public health problem nowadays. As cardiovascular diseases (CVDs) are the primary cause of death in advanced CKD patients, much attention has been paid to resolving their cardiovascular complications. However, managing CKD and cardiovascular complications is still a big challenge for nephrologists, as satisfactory treatments are still lacking. Platelets, the second most abundant cells in the blood, are the major participants of hemostasis, thrombosis, and wound healing. In recent years, platelets have been reported in various physiological and pathological processes, including CKD and CKD-related CVDs.

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“…In previous studies, there have been many studies to prove that elevated PDW is related to the occurrence of CVD events. In one study, PLT and PDW are independently associated with CVD events in CKD patients without dialysis [ 29 ]. Another study suggests that pre-procedural PDW may be an independent predictor of both in-hospital and long-term adverse [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…A cohort study suggests that lower PDW values are significantly related to lower risks of CVD [ 28 ]. Moreover, one study has shown that lower platelet counts (PLT) and PDW can predict CVD events in CKD patients without dialysis [ 29 ]. However, there is no research on the interaction between PDW and new-onset CVD in patients undergoing PD.…”

Section: Introductionmentioning

confidence: 99%

The relationship between platelet distribution width and new-onset cardiovascular disease events in patients with peritoneal dialysis

Tang

Zhan

et al. 2022

Renal Failure

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Objectives The global mortality rate from chronic kidney disease (CKD) has increased over the past two decades. Typically, peritoneal dialysis (PD) remains a useful alternative treatment for end-stage renal disease. Cardiovascular disease (CVD) is the main complication in PD patients. In terms of prognosis, it is reported that platelet distribution width (PDW) can predict adverse CVD events. However, the relationship between PDW and new-onset CVD in PD patients is not clear. This study aimed to explore the relationship between PDW and new-onset CVD in PD patients. Methods This was a retrospective cohort study, from 4 July 2005 to 31 December 2019, and a total of 1557 patients were recruited. PDW was respectively categorized into two groups: PDW ≤13.2 fL and PDW >13.2 fL. The primary outcome was a new-onset CVD event. Cox proportional hazards models were performed to assess the hazard ratio (HR). Receiver-operating characteristic (ROC) curves were applied to evaluate the predictive accuracy of the PDW on CVD events. Results During follow-up, 114 new-onset CVD events were recorded. Cox proportional hazards models showed a higher risk of CVD events in patients with high PDW (HR = 1.862 95%CI 1.205–2.877, p = 0.005). Kaplan–Meier cumulative incidence curves showed the risk of the first occurrence of CVD events was greater in the high PDW group ( p = 0.006). Conclusions High PDW is associated with new-onset cardiovascular disease events in PD patients.

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The association between platelet indices and cardiovascular events in chronic kidney disease patients without dialysis

Cited by 10 publications

References 36 publications

Platelet-Dependent Inflammatory Dysregulation in Patients with Stages 4 or 5 Chronic Kidney Disease: A Mechanistic Clinical Study

Platelet-Dependent Inflammatory Dysregulation in Patients with Stages 4 or 5 Chronic Kidney Disease: A Mechanistic Clinical Study

Activated Platelets, the Booster of Chronic Kidney Disease and Cardiovascular Complications

The relationship between platelet distribution width and new-onset cardiovascular disease events in patients with peritoneal dialysis

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