Contribution of platelets indices in the development of contrast-induced nephropathy.
Contrast-induced nephropathy (CIN) accounts for 10% of hospital-acquired renal failure, causes a prolonged in-hospital stay and represents a powerful predictor of poor clinical outcome. The underlying mechanism of the CIN development remains unclear and seems to be multifactorial. The potential link between platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW) with CIN is unknown. Herein, we aimed to investigate the correlation between MPV and PDW levels with the development of CIN. The incidence of CIN (20.5%) was prospectively evaluated in 430 patients with diagnosis of acute coronary syndrome. Initial creatinine (1.13 ± 0.25 vs. 1.05 ± 0.27 mg/dl, P = 0.01) and PDW (40.1 ± 20.2 vs. 34.5 ± 19.9%, P = 0.02) levels and the total volume of contrast media used (121 ± 61 vs. 94 ± 42 ml, P = 0.01) were higher in patients who developed CIN. MPV was similar between the two groups (P = 0.80). In a univariate regression analysis, age, increased creatinine, uric acid, phosphate, PDW levels and higher total volume of contrast media used were significantly correlated with CIN incidence. However, in a multivariate analysis, only total volume of CM used [odds ratio (OR) 1.011, 95% confidence interval (CI) 1.006-1.016; P = 0.01], increased age (OR 1.026, 95% CI 1.00-1.052; P = 0.05) and increased PDW levels (OR 1.009, 95% CI 1.00-1.022; P = 0.04) remained as the independent predictors of CIN. Among platelet indices, PDW, but not MPV, was associated with CIN development. The clinical significance of such link remains unclear, but may indicate involvement of platelet activation in CIN pathogenesis.
aDepartment of Cardiology, Bagcilar Public Education and Research Hospital bDepartment of Cardiology, Istanbul Medicine Hospital cDepartment of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey dJohns Hopkins University, Baltimore, Maryland, USA.
Irfan
I
Sahin
Ahmet
A
Karabulut
Ilhan Iker
II
Avci
Ertugrul
E
Okuyan
Halil I
HI
Biter
Suleyman S
SS
Yildiz
Mehmet M
MM
Can
Baris
B
Gungor
Mustafa
M
Dinckal
Victor
V
Serebruany
D054058:Acute Coronary Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D000368:Aged; D001792:Blood Platelets / Q000502:physiology* / Q000648:ultrastructure; D006328:Cardiac Catheterization; D048429:Cell Size; D015897:Comorbidity; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D015539:Platelet Activation; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
D003287:Contrast Media; D003404:Creatinine