Abstract: FR-PO0049
Associations of Platelet Counts with AKI and Mortality in Critically Ill Patients with Community-Acquired Pneumonia: A Multicenter Retrospective Study
Session Information
- AKI: Epidemiology, Risk Factors, and Prevention
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Chen, Mengxing, Nanjing First Hospital, Nanjing, Jiangsu, China
- Ma, Mengqing, Nanjing First Hospital, Nanjing, Jiangsu, China
- Zhang, Kaiqiang, China Pharmaceutical University, Nanjing, Jiangsu, China
- Wan, Xin, Nanjing First Hospital, Nanjing, Jiangsu, China
- Cao, Changchun, Nanjing First Hospital, Nanjing, Jiangsu, China
Background
Community-acquired pneumonia (CAP) is a leading cause of intensive care unit (ICU) admissions and mortality. Acute kidney injury (AKI) frequently complicates CAP in critically ill patients, yet the relationship between platelet counts (PLT) and AKI risk and outcomes remains poorly defined.
Methods
We conducted a multicenter retrospective study using data from three hospitals in China (n=1,878) and the eICU database (n=3,565). Associations between static PLT (first-, min-, and last-) and AKI incidence, severity, recovery, and mortality were analyzed. Dynamic PLT changes were evaluated using generalized additive mixed models (GAMM), and potential causal associations were explored via Mendelian randomization (MR).
Results
Lower minimum PLT was independently associated with increased AKI risk, greater severity, and reduced recovery (aOR: 0.618–0.706; P<0.001). Lower last PLT was strongly linked to ICU and in-hospital mortality (aOR: 0.450–0.505; P<0.001). Restricted cubic splines and threshold analysis indicated that PLT levels below specific thresholds showed nonlinear associations with AKI risk, recovery, and mortality. GAMM showed rapid PLT decline and slower recovery in patients with adverse outcomes. However, MR analysis did not support a causal role for genetically predicted PLT in AKI.
Conclusion
Both static and dynamic PLT levels are significant prognostic markers for AKI and mortality in critically ill CAP patients. However, MR suggests that there is no direct causal link between the PLT and acute renal failure, warranting further investigation into the underlying mechanisms involved.
Funding
- Government Support – Non-U.S.