The following is a summary of “Association between perioperative platelet distribution width changes and postoperative acute kidney injury in patients with renal insufficiency: a retrospective study,” published in the November 2024 issue of Nephrology by Su et al.
AKI is common after cardiac surgery in patients with kidney dysfunction. Platelet distribution width (PDW) may indicate acute kidney injury (AKI) risk.
Researchers conducted a retrospective study on PDW changes and AKI. They found PDW changes could predict AKI risk.
They enrolled patients with preoperative renal dysfunction [15 ≤ estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2] who underwent cardiac surgery from January 2018 to December 2021. PDW values were measured preoperatively and post-surgery, with dPDW defined as the difference. Multivariate regression, spline analysis, and the Youden index assessed the association between dPDW and AKI, with subgroup analysis for consistency.
The results showed AKI occurred in 53.10% (513/966) of patients, with significant PDW increases (P < 0.001). After adjusting for confounders, dPDW was a significant AKI risk factor (OR = 1.09, 95% CI: 1.02–1.16, P = 0.012). Patients in the highest dPDW quartile had 195% higher AKI risk (OR = 2.95, 95% CI: 1.78–4.90, P < 0.001). Trend analysis showed increased AKI risk with higher dPDW quartiles (P for trend < 0.001). The optimal dPDW cut-off for AKI was 1.1. Subgroup analyses confirmed a consistent association (P for interaction > 0.05).
They identified perioperative PDW changes as a key predictor of postoperative AKI in patients with renal insufficiency. This emphasized its potential to enhance risk stratification and inform management strategies.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03802-9
