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

Abstract

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.

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

“…As the most common complication, CVD is currently considered to be the main cause of death in patients with chronic kidney disease (CKD) and PD [ 3 , 4 ]. Recent studies have suggested that inflammation and thrombosis play a critical role in the occurrence of CVD in CKD patients [ 7 , 12 ]. Platelets are not only a key component in regulating hemostasis and thrombosis, but also related to inflammation [ 12 ].…”

“…Recent studies have suggested that inflammation and thrombosis play a critical role in the occurrence of CVD in CKD patients [ 7 , 12 ]. Platelets are not only a key component in regulating hemostasis and thrombosis, but also related to inflammation [ 12 ]. PDW is a specific marker reflecting platelet activity [ 6 ].…”

“…High PDW has been demonstrated to be associated with atherosclerosis, coronary artery disease, cerebrovascular disease, and systemic inflammatory disease, and it can be an independent predictor of poor prognosis in patients with heart failure [ 14 ]. 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 ].…”