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. 2020 Oct 10;63(4):353-359.
doi: 10.33160/yam.2020.11.008. eCollection 2020 Nov.

Hematological Parameters and Clinical Features in Patients with Advanced Chronic Kidney Disease

Ertugrul Erken  1 , Cansu Ulgen  2 , Feyza Nur Sarisik  2 , Neziha Erken  3 , Ozkan Gungor  1 , Orcun Altunoren  1
Affiliations

Hematological Parameters and Clinical Features in Patients with Advanced Chronic Kidney Disease

Ertugrul Erken et al. Yonago Acta Med. .

Abstract

Background: Hematological parameters like red cell distribution width (RDW) and mean platelet volume (MPV) were reported to be associated with inflammation, atherosclerosis, and chronic kidney disease (CKD) progression. In this study, we evaluated RDW and MPV along with clinical features in patients with advanced CKD. We also aimed to detect clues for causative relations concerning these parameters, renal function and comorbidities.

Methods: Stage 3-5 CKD patients (627 total) were included (mean age 63.1 years, 48.3% male). Patients with malignancies, cirrhosis, infections, severe anemia, and systemic inflammation were excluded. Patients were evaluated for clinical features and grouped for comparison using median RDW and MPV. Linear regression models were generated to predict potential influences on RDW and MPV.

Results: Mean estimated glomerular filtration rate (eGFR) was 27.3 mL/min/1.73m2. Mean Charlson Comorbidity Index (CCI) score was 5.83 ± 2.06. Patients with high RDW (n = 303) were older with higher CRP and CCI, they also had lower eGFR, hemoglobin, and albumin (P < 0.001 for all). Patients with low MPV (n = 311) had lower eGFR, and platelet counts (P = 0.015 and 0.017). eGFR was negatively correlated with RDW after adjusting for age, gender and comorbidities. In a further adjusted model RDW was associated with CRP, CCI, hemoglobin and albumin (P < 0.05 for all), not with eGFR. MPV was positively correlated with eGFR in our adjusted, and fully adjusted regression models (P = 0.003).

Conclusion: In this study, we found that high RDW is associated with comorbidity burden, anemia, and inflammatory status in patients with advanced CKD. Meanwhile, low MPV seems to be associated with worse renal function.

Keywords: blood platelets; chronic kidney failure; erythrocyte indices; mean platelet volume; red cell distribution width.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.
Comparison of RDW and MPV values of the patients according to CKD stages. RDW was higher in stage 5 CKD patients compared to stage 3 CKD patients. MPV was lower in stage 5 CKD patients compared to stage 3 and stage 4 CKD patients. CKD, chronic kidney disease; MPV, mean platelet volume; RDW, red cell distribution width.
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