Effect of Mean Platelet Volume to Platelet Count Ratio on Mortality in Peritoneal Dialysis

Abstract

Background and Aims. Mean platelet volume to platelet count ratio (MPV/PC) has been found to be an independent risk factor for mortality in various diseases, including cardiovascular disease, cancer, and hemodialysis. We aimed to evaluate the association between MPV/PC and all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients. Methods and Results. We conducted a retrospective cohort study at a single center and enrolled 1473 PD patients who were catheterized at our PD center from January 1, 2006, to December 31, 2013. All patients were divided into four groups according to the quartiles of baseline MPV/PC levels and followed up until December 31, 2018. A total of 453 patients died, and 221 deaths were caused by cardiovascular disease during a median follow-up time of 48.0 (21.9-82.2) months. There was a significant interaction by age of association between MPV/PC level and all-cause mortality ( $P=0.009$ ), and multivariate Cox regression analysis showed that higher MPV/PC level was related to a decreased risk of all-cause and CV mortality in PD patients $\text{aged}<60$ years ( $\text{HR}=0.62$ , $95\%\text{CI}=0.40-0.96$ , $P=0.032$ ; $\text{HR}=0.49$ , $95\%\text{CI}=0.26-0.93$ , $P=0.029$ , respectively), rather than in patients $\text{aged}\ge 60$ years ( $\text{HR}=1.37$ , $95\%\text{CI}=0.84-2.22$ , $P=0.208$ ; $\text{HR}=1.50$ , $95\%\text{CI}=0.77-2.92$ , $P=0.237$ , respectively). Conclusion. Our results indicated that low MPV/PC level was an independent risk factor for all-cause and CV mortality in PD patients aged less than 60 years.