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Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS
BACKGROUND: Hemodialysis (HD) patients have a higher mortality rate compared with general population. Our previous study revealed that platelet counts might be a potential risk factor. The role of platelets in HD patients has rarely been studied. The aim of this study is to examine if there is an as...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722075/ https://www.ncbi.nlm.nih.gov/pubmed/34979949 http://dx.doi.org/10.1186/s12882-021-02579-5 |
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author | Zhao, Xinju Niu, Qingyu Gan, Liangying Hou, Fan Fan Liang, Xinling Ni, Zhaohui Chen, Xiaonong Chen, Yuqing McCullough, Keith Robinson, Bruce Zuo, Li |
author_facet | Zhao, Xinju Niu, Qingyu Gan, Liangying Hou, Fan Fan Liang, Xinling Ni, Zhaohui Chen, Xiaonong Chen, Yuqing McCullough, Keith Robinson, Bruce Zuo, Li |
author_sort | Zhao, Xinju |
collection | PubMed |
description | BACKGROUND: Hemodialysis (HD) patients have a higher mortality rate compared with general population. Our previous study revealed that platelet counts might be a potential risk factor. The role of platelets in HD patients has rarely been studied. The aim of this study is to examine if there is an association of thrombocytopenia (TP) with elevated risk of all-cause mortality and cardiovascular (CV) death in Chinese HD patients. METHODS: Data from a prospective cohort study, China Dialysis Outcomes and Practice Patterns Study (DOPPS) 5, were analyzed. Demographic data, comorbidities, platelet counts and other lab data, and death records which extracted from the medical record were analyzed. TP was defined as the platelet count below the lower normal limit (< 100*10(9)/L). Associations between platelet counts and all-cause and CV mortality were evaluated using Cox regression models. Stepwise multivariate logistic regression was used to identify the independent associated factors, and subgroup analyses were also carried out. RESULTS: Of 1369 patients, 11.2% (154) had TP at enrollment. The all-cause mortality rates were 26.0% vs. 13.3% (p < 0.001) in patients with and without TP. TP was associated with higher all-cause mortality after adjusted for covariates (HR:1.73,95%CI:1.11,2.71), but was not associated with CV death after fully adjusted (HR:1.71,95%CI:0.88,3.33). Multivariate logistic regression showed that urine output < 200 ml/day, cerebrovascular disease, hepatitis (B or C), and white blood cells were independent impact factors (P < 0.05). Subgroup analysis found that the effect of TP on all-cause mortality was more prominent in patients with diabetes or hypertension, who on dialysis thrice a week, with lower ALB (< 4 g/dl) or higher hemoglobin, and patients without congestive heart failure, cerebrovascular disease, or hepatitis (P < 0.05). CONCLUSION: In Chinese HD patients, TP is associated with higher risk of all-cause mortality, but not cardiovascular mortality. Platelet counts may be a useful prognostic marker for clinical outcomes among HD patients, though additional study is needed. |
format | Online Article Text |
id | pubmed-8722075 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87220752022-01-06 Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS Zhao, Xinju Niu, Qingyu Gan, Liangying Hou, Fan Fan Liang, Xinling Ni, Zhaohui Chen, Xiaonong Chen, Yuqing McCullough, Keith Robinson, Bruce Zuo, Li BMC Nephrol Research BACKGROUND: Hemodialysis (HD) patients have a higher mortality rate compared with general population. Our previous study revealed that platelet counts might be a potential risk factor. The role of platelets in HD patients has rarely been studied. The aim of this study is to examine if there is an association of thrombocytopenia (TP) with elevated risk of all-cause mortality and cardiovascular (CV) death in Chinese HD patients. METHODS: Data from a prospective cohort study, China Dialysis Outcomes and Practice Patterns Study (DOPPS) 5, were analyzed. Demographic data, comorbidities, platelet counts and other lab data, and death records which extracted from the medical record were analyzed. TP was defined as the platelet count below the lower normal limit (< 100*10(9)/L). Associations between platelet counts and all-cause and CV mortality were evaluated using Cox regression models. Stepwise multivariate logistic regression was used to identify the independent associated factors, and subgroup analyses were also carried out. RESULTS: Of 1369 patients, 11.2% (154) had TP at enrollment. The all-cause mortality rates were 26.0% vs. 13.3% (p < 0.001) in patients with and without TP. TP was associated with higher all-cause mortality after adjusted for covariates (HR:1.73,95%CI:1.11,2.71), but was not associated with CV death after fully adjusted (HR:1.71,95%CI:0.88,3.33). Multivariate logistic regression showed that urine output < 200 ml/day, cerebrovascular disease, hepatitis (B or C), and white blood cells were independent impact factors (P < 0.05). Subgroup analysis found that the effect of TP on all-cause mortality was more prominent in patients with diabetes or hypertension, who on dialysis thrice a week, with lower ALB (< 4 g/dl) or higher hemoglobin, and patients without congestive heart failure, cerebrovascular disease, or hepatitis (P < 0.05). CONCLUSION: In Chinese HD patients, TP is associated with higher risk of all-cause mortality, but not cardiovascular mortality. Platelet counts may be a useful prognostic marker for clinical outcomes among HD patients, though additional study is needed. BioMed Central 2022-01-03 /pmc/articles/PMC8722075/ /pubmed/34979949 http://dx.doi.org/10.1186/s12882-021-02579-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Zhao, Xinju Niu, Qingyu Gan, Liangying Hou, Fan Fan Liang, Xinling Ni, Zhaohui Chen, Xiaonong Chen, Yuqing McCullough, Keith Robinson, Bruce Zuo, Li Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS |
title | Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS |
title_full | Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS |
title_fullStr | Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS |
title_full_unstemmed | Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS |
title_short | Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS |
title_sort | thrombocytopenia predicts mortality in chinese hemodialysis patients- an analysis of the china dopps |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722075/ https://www.ncbi.nlm.nih.gov/pubmed/34979949 http://dx.doi.org/10.1186/s12882-021-02579-5 |
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