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

  • Nephrology - Original Paper
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Abstract

Purpose

Previous studies have indicated that platelet indices are related to the pathogenesis of cardiovascular diseases (CVD). However, it is unclear which platelet-related indicators are associated with CVD events in patients with chronic kidney disease (CKD) without dialysis.

Methods

We performed a single-center prospective cohort study involved 1391 CKD patients to explore the relationship between platelet indices and CVD events in CKD patients. A nomogram was generated to predict CVD-free survival after 3 and 5 years of follow-up in terms of the fitted Cox regression model. And the time-dependent receiver-operating characteristic (ROC) curves were applied to evaluate the prediction accuracy of platelet indices on CVD events.

Results

During a median follow-up of 3.41 years, 211 (15.2%) patients experienced CVD events. Results showed that platelet counts (PLT), plateletcrit (PCT), platelet-large cell ratio (P-LCR), and platelet distribution width (PDW) among 5 platelet indices were significantly lower in advanced CKD stages. Cox regression model showed that PLT, PDW, and PCT were associated with CVD events. However, after multivariable-adjusted, low level of PLT, hazard ratio (HR) 0.994 and 95% confidence interval (95% CI 0.989–1.000, p = 0.04), and PDW, HR 0.936 (95% CI 0.878–0.998, p = 0.044) predicted CVD events. The area under the ROC curve (AUC) of platelet indices assessed by time-dependent ROC curve analysis showed that only PLT and PDW were significant for predicting CVD events for 5 years.

Conclusions

We demonstrated that PLT and PDW among 5 platelet indices were independently associated with CVD events in patients with CKD.

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Data availability

Data can be obtained from the corresponding author on reasonable request.

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Funding

This work was supported by the Personal Training Program for Clinical Medicine Research of Army Medical University under Grant 2018XLC1007.

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Author notes

  1. Zhikai Yu and Jiachuan Xiong contribute equally to this work.

Authors and Affiliations

  1. Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People’s Republic of China

    Zhikai Yu, Jiachuan Xiong, Ke Yang, Yinhui Huang, Ting He, Yanlin Yu & Jinghong Zhao

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  1. Zhikai Yu
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Contributions

Z.J.H. conceived the idea of the study; Y.Z.K. and X.J.C. analyzed the data; YK., H.Y.H., HT., and Y.Y.L. collected the data and interpreted the results; X.J.C. wrote the paper; all authors discussed the results and revised the manuscript.

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Correspondence to Jinghong Zhao.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number 2018-006-01) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Yu, Z., Xiong, J., Yang, K. et al. The association between platelet indices and cardiovascular events in chronic kidney disease patients without dialysis. Int Urol Nephrol 53, 961–971 (2021). https://doi.org/10.1007/s11255-020-02696-4

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