Mean Platelet Volume Predicts Vascular Access Events in Hemodialysis Patients (original) (raw)

Unravelling the role of MPV/platelets count on vascular access function among haemodialysis Egyptian patients

International journal of health sciences

Background and Aims: End-stage kidney disease (ESKD) is a global health problem. It necessitates renal replacement therapy via renal transplantation, peritoneal dialysis, or hemodialysis. Vascular access is mandatory for every patient maintained on hemodialysis. It is a prerequisite for adequate hemodialysis (HD). Platelets play the most important role in securing vascular access function. Patients and Methods: A retrospective cohort study was conducted on 87 patients who underwent intermittent HD via arteriovenous fistula (AVF). Patients were divided into two groups. Group1 (Study group): patients with recent thrombosed AVF within a week of laboratory investigation. Group2 (Control group): patients with well-functioning AVF Evaluation of patients: Results: The mean platelet volume (MPV), Plateletcrit (PCT), and platelet diameter width (PDW) were 10.43, 0.222, and 13.56 in the study group respectively while in the control group they were 10.11067, 0.201944 and 12.9. MPV/PL count wa...

Significance of platelet activation in vascular access survival of haemodialysis patients

Nephrology Dialysis Transplantation, 2003

Background. Vascular access failure is the most common cause of morbidity and hospitalization in haemodialysis (HD) patients. Although there are reports that anti-platelet agents can prevent vascular access thrombosis, the relationship between platelet activation and vascular access failure is not clear. The aim of this study was to investigate the role of platelet activation in recurrent vascular access failure. Methods. The studied subjects were divided into three groups: group I included 23 HD patients with recurrent vascular access failure (native arteriovenous fistula-2 year survival or synthetic arteriovenous graft-1 year survival), group II included 15 HD patients with longer vascular access survival ()5 year survival) and group III included 10 healthy volunteers as controls. The expression of platelet activation markers (CD62P and fibrinogen receptor) and the numbers of platelet-derived microparticles were measured and compared between groups. Results. CD62P-positive platelets were significantly higher in group I than in both group II (7.3"3.7 vs 3.5"1.3%; P-0.0005) and group III (2.9"0.9%; P-0.00005). Fibrinogen receptor-positive (PAC-1positive) platelets were also significantly higher in group I than in group II (2.2"2.1 vs 0.9"0.7%; P-0.01) and group III (0.8"0.6%; P-0.01). Conclusions. A higher level of circulating activated platelets is associated with shorter survival of vascular access in HD patients. The higher level of circulating activated platelets may be a predictor of recurrent vascular access failure. The potential advantageous effects of anti-platelet therapy on this patient population warrant further investigation.

A comparative study of platelet parameters in end stage renal disease patients undergoing haemodialysis and healthy individuals

International Journal of Advances in Medicine, 2016

Haemodialysis (HD) remains an important form of renal replacement therapy (RRT) in end stage renal disease (ESRD) patients, in developing countries like India it still remains a primary modality of treatment due to growing numbers of ESRD and lack of adequate donors and transplantation centers. The principal cause of morbidity ABSTRACT Background: With the rising trend of diabetes mellitus and hypertension in developing countries like India, there is also a rise in chronic complications like end stage renal disease (ESRD). ESRD poses a huge financial burden on family and health care sector due to a high morbidity and mortality associated with it. Cardiovascular complications remain the most common cause of death among ESRD patients and those undergoing hemodialysis (HD). Hemodialysis patients behave in a distinct way that they are relatively more prone for bleeding than thrombotic manifestations. In recent days abnormalities in platelet parameters are found to be an effective tool in risk stratification of patients with chronic kidney disease (CKD) to develop coronary artery disease. Due to scarcity of literature especially from India, the present study was taken to find the association of various platelet parameters among hemodialysis patients. The aim was to study the platelet distribution width (PDW), mean platelet volume, platelet count, plateletcrit and platelet large cell ratio (PLCR) among ESRD patients undergoing maintenance hemodialysis and compare with healthy age and sex matched controls. Methods: The present study was done on two groups. Group A (Cases) consisting of 40 ESRD patients receiving HD for more than 6 months, and group B (controls) consisting of 40 healthy controls from hospital staffs and healthy volunteers matched for age and sex. Results: The mean values of platelet distribution width (PDW), mean platelet volume, platelet count, plateletcrit and platelet large cell ratio (PLCR) were found to be lower in cases when compared to healthy controls. PDW, platelet count and plateletcrit attained statistical significance, while others did not. Conclusions: Abnormality in platelet parameter to assess CVD risk may be applicable in general population as well as in CKD patients, but its role in hemodialysis patient's further need to be evaluated.

Relationship of arteriovenous fistula stenosis and thrombosis with the platelet–lymphocyte ratio in hemodialysis patients

The Journal of Vascular Access, 2019

Background: The platelet–lymphocyte ratio, which was reported to have a strong relationship with chronic inflammation and thrombosis, is a useful biomarker. The purpose of this study was to evaluate the relationship between the platelet–lymphocyte ratio, arteriovenous stenosis, and thrombosis in patients with chronic renal failure. Methods: Patients who were referred to our interventional radiology department due to arteriovenous fistula dysfunction from dialysis units between August 2015 and December 2018 were retrospectively reviewed. In the study, 95 patients with arteriovenous fistula access problems were included. Patients were divided into two groups: stenosis ( n = 52) and thrombosis ( n = 43). Thirty-six subjects with a patent left radiocephalic arteriovenous fistula proven by both color Doppler ultrasonography and clinically were added to the control group. Blood samples were obtained on the same day before the fistulography. Results: Platelet counts, lymphocyte counts, and...

Early Change In Platelet Count And MPV Levels Of Patients Who Received Hemodialysis For The First Time: Mogadishu Somalia Experience

2022

Introduction. Mean platelet volume (MPV) is a marker used to assess the platelet' size and is also an indicator of platelet reactivity and prothrombotic status. Objective. In this study, we aimed to determine the relationship between MPV and biochemical parameters in patients who had received hemodialysis (HD) for the first time and then in respect of those same patients after their fourth HD. Method. 151 HD patients were enrolled in this study. Patients were eligible for inclusion if they had received their first HD session during this study protocol. Prehemodialysis blood samples were taken. Most laboratory values, including mean platelet volume (MPV) level and platelets (PLT) count, were measured before the first HD and after the fourth HD session for each patient. Results. Among the patients in our study, the mean age profile of the male patients (n � 103; 68.2%) was found to be higher than that of the female patients (n � 48; 31.8%) (53.62 ± 18.19 vs. 46.17 ± 17.9 years) (p � 0.019).In the patients' laboratory results after the fourth HD session, MPV, MPV/Plt, and Na values had increased to those after the first HD session (p < 0.001). When age and gender status were taken into account, the level of weak positive correlation with white blood cell count (WBC), neutrophil, and red cell distribution width (RDW) was found, while the weak negative correlation with platelet to lymphocyte ratio (PLR) was found (p < 0.001). Conclusions. In our study, we found that increase in MPV and MPV/PLT levels was significant in the fourth HD session of patients with CKD. It is also debatable that there are findings indicating an increase in platelet reactivity in the first weeks of the onset of HD. is could be an early indicator of the early prevention of cardiovascular diseases.

The association of demographic, clinical, and thrombophilic factors with the failure of arteriovenous fistula among hemodialysis patients

Saudi medical journal

‫والتخثرية،‬ ‫والسريرية،‬ ‫السكانية،‬ ‫العوامل‬ ‫احتاد‬ ‫تقييم‬ ‫األهداف:‬ ‫اخلاضعني‬ ‫املرضى‬ ‫بني‬ )AVF( ‫الوريدية‬ ‫الشريانية‬ ‫الصارفة‬ ‫فشل‬ ‫مع‬ ‫املزمنة.‬ ‫الدموية‬ ‫للتنقية‬ ‫أنثى)‬ 29 ‫ذكر،‬ 33( ً ‫مريضا‬ 62 ‫الدراسة‬ ‫شملت‬ ‫الطريقة:‬ ‫لدى‬ ‫5002م،‬ ‫مارس‬ ‫في‬ ‫املزمنة‬ ‫الدم‬ ‫تنقية‬ ‫لبرنامج‬ ‫يخضعون‬ ‫تقسيم‬ ‫مت‬ ‫تركيا.‬ -‫دايكل‬ ‫بجامعة‬ ‫الطب‬ ‫بكلية‬ ‫التنقية‬ ‫مركز‬ ‫الثانية)،‬ ‫(املجموعة‬ ‫إليه‬ ‫يحتاجون‬ ‫ما‬ ‫إلى‬ ً ‫وفقا‬ ‫ملجموعتني‬ ‫املرضى‬ ‫أكثر‬ ‫تركيب‬ ‫في‬ ‫األولى)،‬ ‫(املجموعة‬ ‫إليه‬ ‫يحتاجون‬ ‫ماال‬ ‫إلى‬ ‫أو‬ ‫واحدة.‬ ‫صارفة‬ ‫من‬ ‫املجموعة‬ ‫في‬ ً ‫شيوعا‬ ‫األكثر‬ ‫هي‬ ‫اآلتية‬ ‫العوامل‬ ‫كانت‬ ‫النتائج:‬ ‫في‬ ‫إنخفاض‬ ‫نوبات‬ ‫أطول،‬ ‫دم‬ ‫تنقية‬ ‫مدد‬ ‫األنثى،‬ ‫جنس‬ ‫الثانية:‬ ‫فسفور‬ ‫ومركب‬ ‫الفسفور‬ ‫مستوى‬ ‫في‬ ‫إرتفاع‬ ‫التنقية،‬ ‫أثناء‬ ‫الضغط‬ ‫الدرقية‬ ‫جار‬ ‫للغدة‬ ‫طبيعي‬ ‫هرمون‬ ‫ومعدل‬ ،)CaP( ‫الكالسيوم‬ ‫تضخم‬ ‫من‬ ‫أكثر‬ ‫حاالت‬ ‫حدوث‬ ً ‫أيضا‬ ‫لوحظ‬ ‫كما‬ ،)iPTH( .)AVF( ‫األمين‬ ‫القلبي‬ ‫البطني‬ ‫واحلاجة‬ ،)AVF( ‫الوريدية‬ ‫الشريانية‬ ‫الصارفة‬ ‫انفكاك‬ ‫خامتة:‬ ‫مع‬ ،)AVF( ‫الوريدية‬ ‫الشريانية‬ ‫الصارفة‬ ‫تركيب‬ ‫لزيادة‬ ‫املتكررة‬ ‫املتكررة‬ ‫والعوارض‬ ‫األنثى‬ ‫جنس‬ ‫أن‬ ‫نعتقد‬ ‫الدموية.‬ ‫التنقية‬ ‫فترة‬ ‫الفسفور‬ ‫مصل‬ ‫مستوى‬ ‫وارتفاع‬ ‫التنقية،‬ ‫داخل‬ ‫الدم‬ ‫ضغط‬ ‫الرتفاع‬ ‫صلة‬ ‫ذات‬ ‫خطر‬ ‫عوامل‬ ‫تعد‬ )CaP( ‫منتج‬ ‫وارتفاع‬ )iPTH(‫و‬ ‫التنقية‬ ‫مرضى‬ ‫بني‬ )AVF( ‫الوريدية‬ ‫الشريانية‬ ‫الصارفة‬ ‫بفشل‬ ‫الدموية.‬ Objective: To evaluate the association of demographic, clinical, and thrombophilic factors with the failure of arteriovenous fistula (AVF) among patients undergoing chronic hemodialysis.

Renal artery stenosis and mean platelet volume

The Anatolian Journal of Cardiology, 2015

Objective: Increased mean platelet volume (MPV) has been reported in various atherosclerotic diseases. The aim of our study was to investigate the relationship between the atherosclerotic renal artery stenosis (ARAS) and various hematological parameters including MPV. Methods: This study was performed with a retrospective review of the angiographic images of patients who underwent renal angiography at Bülent Ecevit University catheter laboratory between January 2004 and December 2009. The patients were trichotomized into three groups based on the presence and severity of renal artery stenosis (RAS). Group 1 included patients with a critical RAS (33 patients; 18 female (F), 15 male (M); mean age 61.6±11.5 years), group 2 consisted of patients with non-critical RAS (26 patients; 15 F, 11 M; mean age 58.1±11.3 years), and group 3 was composed of patients without RAS (69 patients; 38 F, 31 M; mean age 53.5±11.9 years). Demographic data, complete blood count, and biochemical parameters were compared between the groups. Results: Comparison of the hematological parameters revealed that MPV and platelet distribution width were significantly higher in group 1 than in group 2 and 3 (8.96±0.99 fL versus 8.35±0.76 fL, 8.31±0.79 fL, respectively; p=0.001; 16.53±0.58% versus 16.19±0.56%, 16.29±0.53%, respectively; p=0.04). Conclusion: MPV levels are higher in patients with ARAS. Considering both the effect of platelets on atherosclerosis and their close association with other risk factors, MPV level may be an important factor in pathogenesis of ARAS.

High platelet count as a link between renal cachexia and cardiovascular mortality in end-stage renal disease patients

American Journal of Clinical Nutrition, 2011

Background: It is not clear why cardiac or renal cachexia in chronic diseases is associated with poor cardiovascular outcomes. Platelet reactivity predisposes to thromboembolic events in the setting of atherosclerotic cardiovascular disease, which is often present in patients with end-stage renal disease (ESRD). Objectives: We hypothesized that ESRD patients with relative thrombocytosis (platelet count .300 · 10 3 /lL) have a higher mortality rate and that this association may be related to malnutritioninflammation cachexia syndrome (MICS). Design: We examined the associations of 3-mo-averaged platelet counts with markers of MICS and 6-y all-cause and cardiovascular mortality (2001)(2002)(2003)(2004)(2005)(2006)(2007) in a cohort of 40,797 patients who were receiving maintenance hemodialysis. Results: The patients comprised 46% women and 34% African Americans, and 46% of the patients had diabetes. The 3-mo-averaged platelet count was 229 6 78 · 10 3 /lL. In unadjusted and case-mix adjusted models, lower values of albumin, creatinine, protein intake, hemoglobin, and dialysis dose and a higher erythropoietin dose were associated with a higher platelet count. Compared with patients with a platelet count of between 150 and 200 · 10 3 /lL (reference), the allcause (and cardiovascular) mortality rate with platelet counts between 300 and ,350, between 350 and ,400, and !400 ·10 3 /lL were 6% (and 7%), 17% (and 15%), and 24% (and 25%) higher (P , 0.05), respectively. The associations persisted after control for case-mix adjustment, but adjustment for MICS abolished them. Conclusions: Relative thrombocytosis is associated with a worse MICS profile, a lower dialysis dose, and higher all-cause and cardiovascular disease death risk in hemodialysis patients; and its all-cause and cardiovascular mortality predictability is accounted for by MICS.

Thrombin-Anti-Thrombin Levels and Patency of Arterio-Venous Fistula in Patients Undergoing Haemodialysis Compared to Healthy Volunteers: A Prospective Analysis

PLoS ONE, 2013

Background: Patients on haemodialysis (HD) are at an increased risk of sustaining thrombotic events especially to their vascular access which is essential for maintenance of HD. Objectives: To assess whether 1) markers of coagulation, fibrinolysis or endothelial activation are increased in patients on HD compared to controls and 2) if measurement of any of these factors could help to identify patients at increased risk of arteriovenous (AVF) access occlusion. Patients/Methods: Venous blood samples were taken from 70 patients immediately before a session of HD and from 78 resting healthy volunteers. Thrombin-antithrombin (TAT), D-dimer, von Willebrand factor (vWF), plasminogen activator inhibitor-1 antigen (PAI-1) and soluble p-selectin were measured by ELISA. C-reactive protein (hsCRP) was measured by an immunonephelometric kinetic assay. Determination of the patency of the AVF was based upon international standards and was prospectively followed up for a minimum of four years or until the AVF was nonfunctioning. Results: A total of 70 patients were studied with a median follow-up of 740 days (range 72-1788 days). TAT, Ddimer, vWF, p-selectin and hsCRP were elevated in patients on HD compared with controls. At one year follow-up, primary patency was 66% (46 patients). In multivariate analysis TAT was inversely associated with primary assisted patency (r=-0.250, p= 0.044) and secondary patency (r =-0.267, p= 0.031). Conclusions: The novel finding of this study is that in patients on haemodialysis, TAT levels were increased and inversely correlated with primary assisted patency and secondary patency. Further evaluation is required into the possible role of TAT as a biomarker of AVF occlusion.