We read the article published by Bilen et al.Citation1 with a great interest. They compared mean platelet volume (MPV), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in renal transplanted, hemodialysis, peritoneal dialysis, and chronic renal failure patients. There was no statistically significant difference among the MPV values of all patient groups. This is a well designed and written study and we congratulate the authors for this study. On the other hand, we want to make minor criticism about this study from methodological aspect.
As we know, MPV can be affected by coronary risk factors including type 2 diabetes mellitus, prediabetes, smoking, hypertension, hypercholesterolemia, obesity, coronary heart disease, peripheral artery disease, metabolic syndrome, statins, and some antihypertensive use and atrial fibrillation.Citation2–4 There was no difference between the four groups in terms of age and gender. They also excluded documented coronary artery disease or thromboembolic event. However, they did not mention about body mass index, systolic and diastolic blood pressure values, blood glucose and cholesterol levels, smoking status and drugs used that might have influenced MPV levels like statin and/or antihypertensive agents in patients groups. The MPV values in different chronic kidney disease groups can be affected by these factors. As a result, the authors must have mentioned about these factors. Perhaps MPV would differ in four groups if the authors should have considered these confounding factors.
MPV is universally available with routine blood counts by automated hemograms and a simple and easy method of assessing platelet function. In comparison to smaller ones, larger platelets have more granules, aggregate more rapidly with collagen, have higher thromboxane A2 level and express more glycoprotein Ib and IIb/IIIa receptors.Citation5 Therefore, larger platelets have higher thrombotic potential. MPV is becoming increasingly popular diagnostic marker. It is also associated with many confounding markers as mentioned before. In chronic kidney disease, there is chronic low grade inflammation. In this state, we can expect higher MPV values. High MPV values are associated with low grade inflammatory conditions in addition to the variety of established risk factors, cardiovascular, and cerebrovascular disorders. However, it should be kept in mind that, it is influenced by many cardiovascular risk factors. We believe that, it would be useful, if the authors provided data about these risk factors and their possible relationship with the MPV.
Declaration of interest
The authors have stated explicitly that there are no conflicts of interest in connection with this article.
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References
- Bilen Y, Cankaya E, Keles M, et al. Does decreased mean platelet volume predict inflammation in chronic renal failure, dialysis, and transplanted patients? Ren Fail. 2014;36(1):69--72
- Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases [Review]. Int J Clin Pract. 2009;63(10):1509–1515
- Varol E, Akcay S, Icli A, et al. Mean platelet volume in patients with prehypertension and hypertension. Clin Hemorheol Microcirc. 2010;45(1):67–72
- Varol E, Icli A, Kocyigit S, Erdogan D, Ozaydin M, Dogan A. Effect of smoking cessation on mean platelet volume. Clin Appl Thromb Hemost. 2013;19(3):315–319
- Park Y, Schoene N, Haris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets. 2002;13:301–306