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Abstract: TH-PO269

Platelet Count Has a U-Shaped Association with Mortality in Hemodialysis Patients: A Multinational Analysis of DOPPS

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Zhao, Xinju, Peking University People's Hospital, Beijing, NA, China
  • Zuo, Li, Peking University People's Hospital, Beijing, NA, China
  • Karaboyas, Angelo, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
Background

Based on the role of platelets in coagulation, clot formation, and systemic inflammation, we utilized data from a very large international cohort study to explore the association of platelet counts with mortality and cardiovascular (CV) death in hemodialysis (HD) patients.

Methods

International data from 13,631 patients enrolled in the Dialysis Outcomes and Practice Patterns Study (DOPPS) phase 5 (2012-2015) were analyzed. Participants were divided into 3 groups according to their platelet counts (low: <100, normal: 100-300, high: >300*10^9). Associations between platelet counts and all-cause and CV mortality were analyzed using Cox regression, adjusted for confounders.

Results

Mean platelet count was 205*10^9/L overall and ranged from 173 *10^9/L in China to 227 *10^9/L in Sweden (figure 1). Overall, 2,463 (18 %) patients died and 948 (7%) died from CV disease. Both low (HR=1.5, 95% CI: 1.2, 1.8) and high (HR=1.2; 95% CI: 1.0, 1.4) platelet counts were associated with higher all-cause mortality after adjustment for covariates (Figure 2); results for CV death were consistent.

Conclusion

Platelet count has a U-shaped association with all-cause and CV mortality in HD patients, and thus may be used as an outcome predictor that is readily available among HD patients.

Figure 1. Patients in normal, low, and high platelet groups from 15 countries and areas, A/NZ is for Australia and New Zealand; GCC is for Gulf Cooperation Council (6 countries)

Figure 2. Associations between the platelet counts and all-cause/CV mortality in COX regression model (adjusted for age, gender, BMI, vintage, comorbidities, lab data, Intradialytic weight loss, fistula, primary kidney disease, standard kt/v, urine output < 200 ml/d)