Serum platelet distribution width predicts cardiovascular and all-cause mortality in patients undergoing peritoneal dialysis

ABSTRACT

Background

Platelet distribution width (PDW) is a predictor for all-cause mortality in patients with cardiovascular diseases (CVD). This study aimed to evaluate the prognostic implication of PDW in predicting cardiovascular and all-cause mortality in patients undergoing peritoneal dialysis (PD).

Methods

In total, 762 PD patients from a single center were recruited retrospectively from 2005 to 2017 and followed up until 2021. The primary and secondary outcomes were cardiovascular and all-cause mortality, respectively. Survival analysis was conducted using Kaplan-Meier estimates and Cox regression analysis.

Results

During a median of 52.2 months of follow-up, 135 (17.7%) cases of CVD and 253 (33.2%) cases of all-cause mortality were reported. After multivariate adjustment, high levels of PDW were associated with an increased risk of death from CVD (HR: 1.583; 95% CI: 1.109–2.258; P = 0.011) and all-cause mortality (HR: 1.313; 95% CI: 1.006–1.758; P = 0.045). Subgroup analysis indicated a stronger association between PDW and all-cause mortality among female participants (P-value for interaction = 0.033). Higher levels of PDW predicted an increased risk of all-cause mortality in female patients (HR: 1.986; 95% CI,1.261–3.127).

Conclusion

High levels of PDW are independently associated with cardiovascular and all-cause mortality in the PD population, and differences by sex exist in the association of PDW with all-cause mortality.

KEYWORDS:

• Platelet distribution width
• peritoneal dialysis
• mortality
• cardiovascular disease
• sex differences

Abbreviations

ALB, albumin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CHOL, cholesterol; CK, creatine kinase; CK-MB, creatine kinase myocardial isozyme; CRP, C-reactive protein; CVD, cardiovascular disease; FBS, fasting blood glucose; Hct, hematocrit; HGB, hemoglobin; iPTH, intact parathyroid hormone; MCH, mean corpuscular hemoglobin; MCHC, mean corpuscular hemoglobin concentration; MCV, mean corpuscular volume; P, phosphorus; PD, peritoneal dialysis; PDW, platelet distribution width; PLT, platelet; sCr, serum creatinine; TG, triglyceride; UA, uric acid; WBC, white blood cells.

Acknowledgments

We sincerely thank all the participants enrolled in this study and the medical staff who provided excellent management for these patients at our PD center.

Author contributions

Heng-Mei Zhu and Jun Xiao conceived and designed the study. Heng-Mei Zhu, Yi-Yi Xiong, Yan-Bing Chen and Jun Xiao collected and analyze the data. Heng-Mei Zhu and Yi-Yi Xiong wrote the manuscript. Jun Xiao reviewed the manuscript. All authors read and gave final approval of the version to be published.

Declaration of funding

This work was financially supported by Science and Technology Planning Project of Jiangxi Provincial Health Commission under Grant number 202130143, Natural Science Foundation of Jiangxi Province under Grant number 20181BBG70016, Natural Sciences Foundation-Youth Fund Project of Jiangxi Province under Grant number 20202BAB216007, and the Basic Research Project of Shenzhen Science and Technology Innovation Commission under Grant number JCYJ20190809112003711.

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Data availability statement

Data involved in the present work are available from Dr. Heng-Mei Zhu upon reasonable request.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00325481.2023.2178755.