Platelet indices and incident CKD in high-risk individuals

Platelet indices, including platelet distribution width (PDW) and mean platelet volume (MPV), reflect platelet activation and have been associated with kidney disease progression in various populations. However, whether these indices are associated with incident chronic kidney disease (CKD) in high-risk individuals remains unclear.

We retrospectively examined the associations of PDW and MPV with incident CKD using longitudinal data from 1,281 individuals without CKD but with one or more established CKD risk factors (hypertension, diabetes mellitus, dyslipidemia, or a history of cardiovascular disease) in the Fukushima Cohort Study. Participants were categorized into quartiles according to baseline PDW or MPV. The primary outcome was incident CKD.

During a median follow-up of 5.2 years, 384 participants developed incident CKD. Higher quartiles of PDW and MPV were associated with increased cumulative incidence of CKD in Kaplan-Meier analyses. Compared with the second PDW quartile, the highest quartile was associated with a significantly higher risk of incident CKD (adjusted hazard ratio 1.51, 95% confidence interval 1.11-2.06). A similar association was observed for MPV. However, when PDW and MPV were simultaneously included in the multivariable model, only PDW remained significantly associated with incident CKD, whereas the association of MPV was no longer statistically significant. In addition, analyses treating these indices as continuous variables did not show statistically significant associations.

PDW and MPV showed associations with incident CKD in high-risk individuals; however, these findings were not consistent across all analyses. Therefore, the results should be interpreted as hypothesis-generating and require further confirmation.