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The relationship of platelet distribution width with all-cause and cardiovascular mortality in peritoneal dialysis
Chunyu Lu1, Shuiqin Cheng2, Wenjing Fan2
1Jinling Hospital Department of Nephrology, Nanjing Medical University, Nanjing, PR China.
Insights
Elevated platelet distribution width (PDW) is a significant predictor of mortality in peritoneal dialysis (PD) patients. Higher PDW levels are independently associated with increased risks of both all-cause and cardiovascular mortality in this population.
Area of Science:
- Nephrology
- Cardiology
- Hematology
Background:
- Cardiovascular disease (CVD) is a significant complication for patients undergoing peritoneal dialysis (PD).
- Platelet distribution width (PDW) has been linked to cardiovascular events in hemodialysis (HD) patients.
- The predictive value of PDW for mortality in PD patients remains to be fully elucidated.
Purpose of the Study:
- To investigate the association between elevated platelet distribution width (PDW) and all-cause and cardiovascular mortality in peritoneal dialysis (PD) patients.
- To determine if PDW can serve as an independent predictor of mortality in PD patients.
Main Methods:
- A retrospective cohort study involving 426 PD patients after propensity score matching (PSM).
- Receiver-operating characteristic (ROC) curves were used to identify PDW cutoff values.
- Cox proportional hazards models and restricted cubic spline (RCS) analyses were employed to assess the relationship between PDW and mortality.
Main Results:
- After adjusting for confounders, PDW was positively correlated with the risk of all-cause mortality (HR = 1.162) and cardiovascular mortality (HR = 1.200).
- The relationship between PDW and both all-cause and cardiovascular mortality was found to be linear through adjusted RCS analysis.
Conclusions:
- Elevated platelet distribution width (PDW) is an independent risk factor for all-cause and cardiovascular mortality in patients on peritoneal dialysis (PD).
- PDW may serve as a valuable prognostic biomarker in the management of PD patients.
Background:
Cardiovascular disease (CVD) is a major complication in peritoneal dialysis (PD) patients. Previous studies have demonstrated that platelet distribution width (PDW) is associated with cardiovascular events in hemodialysis (HD) patients. In this study, we hypothesized that elevated PDW can predict all-cause and cardiovascular mortality in PD patients.
Methods:
We recruited PD patients for a single-center retrospective cohort study from 1 January 2007, to 30 June 2020. Receiver-operating characteristic (ROC) curves were made to determine the PDW cutoff value for predicting all-cause mortality. The propensity score matching (PSM) method was used to improve the equilibrium between groups. The relation of PDW with all-cause and cardiovascular mortality was analyzed by Cox proportional hazards models. Restricted cubic spline (RCS) models were used to determine whether there was a linear relationship between PDW and all-cause and cardiovascular mortality.
Results:
A total of 720 PD patients were screened, and 426 PD patients were enrolled after PSM. After adjusting for confounders, Cox proportional hazards models showed that the PDW value was positively correlated with the risk of all-cause and cardiovascular mortality (HR = 1.162, 95% CI 1.057-1.278, p = 0.002 and HR = 1.200, 95% CI 1.041-1.382, p = 0.012). The adjusted RCS analysis further showed that the relationship of PDW with all-cause and cardiovascular mortality was linear (p for nonlinearly = 0.143 and 0.062).
Conclusion:
Elevated PDW is independently associated with all-cause and cardiovascular mortality in PD patients.
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