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

Abstract

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.

Keywords:

• Platelet distribution width
• peritoneal dialysis
• all-cause mortality
• cardiovascular mortality
• propensity score matching

Acknowledgment

The authors thank all members of the National Clinical Research Center of Kidney Disease, for their helpful advice and discussions.

Author contributions

Chunyu Lu and Shuiqin Cheng contributed equally to this work; Jinquan Wang conceived and designed the study; Chunyu Lu and Shuiqin Cheng analyzed the data and wrote the article; Wenjing Fan and Zhihong Zhang collected the data; Jinquan Wang reviewed and edited the manuscript.

Disclosure statement

The authors have no conflicts of interest to declare.

Ethical approval

This study was approved by the Ethics Committee of Jinling Hospital [No.2023DZKY-003-01] and was in accordance with the Helsinki Declaration of 1975. The informed consent was waived due to the retrospective study design.

Data availability statement

The datasets in this study are available from the corresponding author on reasonable request.

Additional information

Funding

This study was supported by grants from the National Natural Science Foundation of China (No.82370714) and the Key Research and Development Project of Jiangsu Province (No.BE2020698).