#322 Are platelet-related parameters prognostic predictors of renal and cardiovascular outcomes in IgA nephropathy?

Abstract

Abstract Background and Aims IgA nephropathy (IgAN) is associated with chronic inflammation. Platelet-related parameters, such as platelet (PLT) count, platelet-to-albumin ratio (PAR) and platelet-to-lymphocyte ratio (PLR), were examined as potential prognostic indicators for renal and cardiovascular (CV) outcomes in IgAN. Method 150 IgAN patients were involved and divided into two groups based on the cut-off value of PAR. All-cause mortality, major CV events and end-stage renal disease were the primary combined endpoints. Secondary endpoints, such as CV or renal endpoints, were also analyzed separately. Results Seventy-four per cent of patients were male and had a mean age of 43.7 ± 13.5 years. Mean follow-up time: 124 ± 67 months. The K-M curve showed that PLT, PLR and PAR were strongly associated with primary combined and renal outcomes, but not with cardiovascular outcomes in IgAN. In the case of combining PAR with LVH, the K-M curves showed significant differences in both the primary (p < 0.001) and secondary outcomes (p = 0.001 and p = 0.038). When we combined PAR with metabolic syndrome, the primary (p < 0.001) and secondary (p = 0.001 and p = 0.015) outcomes were also significant in the low and high PAR groups. PAR was correlated with gender (r = -0.273, p = 0.001) and segmental glomerulosclerosis on histology (r = 0.161, p = 0.047). PLR correlated with microalbuminuria (r = -0.165, p = 0.033) and left ventricular hypertrophy (r = -0.178, p = 0.025). PLT was correlated with gender (r = -0.201, p = 0.013) and eGFR (r = 0.158, p = 0.040). PLR, gender, dyslipidemia and microalbuminuria were associated with the primary composite endpoints; left ventricular hypertrophy and microalbuminuria with the secondary renal endpoints; and gender, age and diabetes with the cardiovascular endpoints by multivariate Cox regression. Conclusion Elevated PAR and PLR may predict end-stage renal disease progression, but in combination with LVH and MetS, they showed CV events also in IgAN. The determination of PAR and PLR can be useful and cost-effective parameters for assessing both cardiovascular and renal risks in CKD.