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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 
 JOURNAL OF CRITICAL CARE, Vol.29(6) : 1016-1021, 2014 
Journal Title
Issue Date
APACHE ; Acute Kidney Injury/blood ; Acute Kidney Injury/mortality* ; Acute Kidney Injury/therapy* ; Adult ; Aged ; Area Under Curve ; Blood Platelets ; Cause of Death ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Mean Platelet Volume* ; Middle Aged ; Prognosis ; Proportional Hazards Models ; ROC Curve ; Renal Replacement Therapy/methods* ; Retrospective Studies
Acute kidney injury ; Continuous renal replacement therapy ; Mean platelet volume ; Mortality ; Platelet
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Koo, Hyang Mo(구향모)
Kim, Eun Jin(김은진)
Kim, Chan Ho(김찬호)
Doh, Fa Mee(도화미) ORCID logo https://orcid.org/0000-0002-4780-6728
Park, Kyoung Sook(박경숙)
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Oh, Hyung Jung(오형중)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Mi Jung(이미정)
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
Han, Jae Hyun(한재현)
Hahn, Jee Sook(한지숙)
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