Mean platelet volume is a prognostic factor in patients with acute kidney injury requiring continuous renal replacement therapy

Ji Suk Han, Kyoung Sook Park, Mi Jung Lee, Chan Ho Kim, Hyang Mo Koo, Fa Mee Doh, Eun Jin Kim, Jae Hyun Han, Jung Tak Park, Seung Hyeok Han, Tae Hyun Yoo, Shin Wook Kang, Hyung Jung Oh

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Purpose: Platelet size has been demonstrated to reflect platelet activity and to predict poor clinical outcomes in patients with cardiovascular disease. However, the prognostic value of platelet size for mortality has not been studied in patients with acute kidney injury (AKI). Materials and methods: A total of 349 patients who received continuous renal replacement therapy (CRRT) for AKI between August 2009 and October 2011 were divided into 2 groups based on the median mean platelet volume (MPV) at the time of CRRT initiation. Twenty-eight-day mortality rate was determined using Kaplan-Meier plots and time-dependent receiver operating characteristic curves were constructed. In addition, multivariate Cox analysis for mortality was used to evaluate the independent prognostic value of MPV. Results: The mean age was 61.3 years, and 218 patients (62.5%) were male. At the initiation of CRRT, MPV level was inversely correlated with platelet count, whereas it was positively associated with Acute Physiology and Chronic Health Evaluation II scores. During the study period, 231 deaths (66.2%) occurred. Kaplan-Meier curve showed that 28-day all-cause mortality was significantly higher in patients with MPV ≥ 10.2 fL compared with those with MPV < 10.2 fL (P < .001). Moreover, Cox regression analysis revealed that MPV was an independent predictor for 28-day all-cause mortality after adjustment of age, age-adjusted Charlson Comorbidity Index, cause of AKI, platelet count, Acute Physiology and Chronic Health Evaluation II score, presence of malignancy, albumin, and C-reactive protein (hazard ratio, 1.080; 95% confidence interval, 1.010-1.155; P = .023). Conclusion: Mean platelet volume at the time of CRRT initiation may be an inexpensive and useful predictor for 28-day all-cause mortality in patients with AKI requiring CRRT.

Original languageEnglish
Pages (from-to)1016-1021
Number of pages6
JournalJournal of Critical Care
Volume29
Issue number6
DOIs
Publication statusPublished - 2014 Dec 1

Bibliographical note

Funding Information:
This work was supported by the Brain Korea 21 Project for Medical Science, Yonsei University ; by the National Research Foundation of Korea grant funded by the Korea government (MEST; No. 2011-0030711 ); and by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea ( HI10C2020 ).

Publisher Copyright:
© 2014 Elsevier Inc.

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

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