Platelet Distribution Width and Mortality in Hemodialysis Patients

Objectives. The association between platelet distribution width (PDW) and mortality in hemodialysis (HD) patients has received little attention. Methods. We retrospectively enrolled HD patients in a single center from January 1, 2008, to December 30, 2011. The primary and secondary endpoints were all-cause and cardiovascular mortality, respectively. The association between PDW and mortality was estimated by Cox regression model. Results. Of 496 patients, the mean age was 52.5 +/- 16.6 years, and the Charlson comorbidity index was 4.39 +/- 1.71. During the follow-up period of 48.8 +/- 6.7 months, 145 patients (29.2%) died, including 74 (14.9%) cardiovascular deaths. 258 (52.0%) with PDW < 16.31% were in the low group and 238 (48.0%) in those with PDW >= 16.31% according to cut-off for all-cause mortality by receiving-operator characteristics. After adjusting for confounding factors, high PDW values were independently associated with higher risk of all-cause (hazards ratio (HR) = 1.49, 95% confidence interval (CI) 1.15-6.82) and cardiovascular deaths (HR = 2.26, 95% CI 1.44-3.63) in HD patients. When comparing with quartile 1 of PDW, quartile 4 of PDW was independently associated with a higher risk of all-cause (HR = 1.59, 95% CI 1.18-5.30) and cardiovascular deaths (HR = 2.71, 95% CI 1.49-3.76) in HD patients. Conclusions. Baseline PDW was independently associated with all-cause and cardiovascular mortality in HD patients.