Liao Ruoxi, Zhou Xueli, Ma Dengyan, Tang Jing, Zhong Hui
Department of Nephrology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
J Ren Nutr. 2022 Sep;32(5):587-594. doi: 10.1053/j.jrn.2021.09.004. Epub 2022 Mar 24.
Iron deficiency is common in patients with end-stage renal disease (ESRD). Platelet count changes may reflect iron status, but the relationship between platelet count and iron indices is unclear in patients with ESRD.
We conducted a retrospective study in 1,167 patients with ESRD from 2012 to 2017 in West China Hospital. Baseline data were used to analyze the relationship between the platelet count and iron indices. Patients were followed up for 3 years.
Patients with iron deficiency (both absolute and functional) had a higher platelet count than those without iron deficiency (174 ± 61 × 10/L vs. 153 ± 58 × 10/L, P < .001). Receiver operating characteristic analysis showed a weak predictive power of platelet count on absolute iron deficiency (area under curve 0.620; cutoff value > 137 × 10/L, sensitivity 76%, specificity 43%) and functional iron deficiency (area under curve 0.540; cutoff value > 124 × 10/L, sensitivity 77%, specificity 32%). Platelet count was negatively correlated with ferritin (Spearman's rho [ρ] -0.1547, P < .001), transferrin saturation (ρ = -0.1895, P < .001), and serum iron (ρ = -0.1466, P < .001). The abovementioned correlations remained significant in multivariate regression (β -0.7285, 95% confidence interval [CI] -1.0757 to -0.3814; β -.00347, 95% CI -0.0520 to -0.0174; β -0.0097, 95% CI -0.0159 to -0.0035, respectively). In unadjusted and adjusted Cox regression models, neither baseline platelet count nor relative thrombocytosis was associated with 3-year mortality.
There was a weak but significant platelet count elevation in patients with ESRD and with iron deficiency.
缺铁在终末期肾病（ESRD）患者中很常见。血小板计数变化可能反映铁状态，但ESRD患者血小板计数与铁指标之间的关系尚不清楚。
我们对2012年至2017年在华西医院的1167例ESRD患者进行了一项回顾性研究。利用基线数据分析血小板计数与铁指标之间的关系。对患者进行了3年的随访。
缺铁（绝对缺铁和功能性缺铁）患者的血小板计数高于无缺铁患者（174±61×10⁹/L对153±58×10⁹/L，P<.001）。受试者工作特征分析显示血小板计数对绝对缺铁（曲线下面积0.620；临界值>137×10⁹/L，敏感性76%，特异性43%）和功能性缺铁（曲线下面积0.540；临界值>124×10⁹/L，敏感性77%，特异性32%）的预测能力较弱。血小板计数与铁蛋白（Spearman秩相关系数[ρ]-0.1547，P<.001）、转铁蛋白饱和度（ρ=-0.1895，P<.001）和血清铁（ρ=-0.1466，P<.001）呈负相关。在多变量回归中上述相关性仍然显著（β-0.7285，95%置信区间[CI]-1.0757至-0.3814；β-.00347，95%CI-0.0520至-0.0174；β-0.0097，95%CI-0.0159至-0.0035，分别）。在未调整和调整后的Cox回归模型中，基线血小板计数和相对性血小板增多均与3年死亡率无关。
ESRD且缺铁患者的血小板计数有微弱但显著的升高。
