Department of Nephrology, First Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Nephrology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China.
Postgrad Med. 2023 May;135(4):394-401. doi: 10.1080/00325481.2023.2178755. Epub 2023 Feb 21.
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).
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.
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).
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.
血小板分布宽度(PDW)是心血管疾病(CVD)患者全因死亡率的预测指标。本研究旨在评估 PDW 在预测腹膜透析(PD)患者心血管和全因死亡率方面的预后意义。
本研究回顾性地招募了 2005 年至 2017 年期间来自单一中心的 762 名 PD 患者,并随访至 2021 年。主要和次要结局分别为心血管和全因死亡率。使用 Kaplan-Meier 估计和 Cox 回归分析进行生存分析。
在中位 52.2 个月的随访期间,报告了 135 例(17.7%)CVD 和 253 例(33.2%)全因死亡病例。经过多变量调整后,高水平的 PDW 与 CVD 死亡风险增加相关(HR:1.583;95%CI:1.109-2.258;P=0.011)和全因死亡率(HR:1.313;95%CI:1.006-1.758;P=0.045)。亚组分析表明,PDW 与女性参与者全因死亡率之间的相关性更强(交互 P 值=0.033)。较高的 PDW 预示着女性患者全因死亡风险增加(HR:1.986;95%CI,1.261-3.127)。
高水平的 PDW 与 PD 人群的心血管和全因死亡率独立相关,PDW 与全因死亡率的相关性存在性别差异。