MO676: The Ratio Mean Platelet Volume/Platelet Count in Peritoneal Dialysis: Effect of Dialysis and Peritoneal Transport Status

Abstract

Abstract BACKGROUND AND AIMS Mean platelet volume (MPV) is gaining scientific interest with regard to cardiovascular risk stratification. The MPV/platelet count ratio seems to be more specific than MPV alone as a surrogate parameter for platelet activation. The MPV/platelet ratio might be of interest in peritoneal dialysis (PD) as the distribution and integrity of endothelial–platelet interaction in the abdominal space determines its function. The aim of the study was to evaluate the modification of MPV/platelet ratio due to dialysis and its association to peritoneal transport status. METHOD In 123 PD patients (median age 65 years) MPV and platelet count were measured together with anthropometric patient data and peritoneal function at catheter placement and after 6 months during the first peritoneal equilibration test (PET). MPV and platelet count were determined with a fully automated hematological analyser. Correlation analysis was performed. RESULTS The MPV/platelet ratio decreased significantly from 3.99% at placement to 3.50% at the first PET (median values, Wilcoxon test P < 0.001). Neither anthropometric data, nor creatinine clearance, nor BUN clearance, nor Kt/V (renal, peritoneal, total), nor erythrocyte sedimentation rate, nor C reactive protein were associated to MPV/platelet ratio. Only dialysate to plasma (D/P) urea and D/P creatinine were significantly correlated to MPV/platelet ratio (D/P urea r = 0.223, P = 0.01; D/P creatinine r = 0.199, P = 0.03). Slow transporters presented a significantly lower MPV/platelet ratio than average transporters (median values, 3.49% versus 3.83%, Mann–Whitney test P = 0.03). CONCLUSION PD is reducing significantly the MPV/platelet ratio. Differences in MPV/platelet ratio are reflected in the peritoneal transport status at 6 months after dialysis start. The reduction of the MPV/platelet ratio might respect a reduced platelet and endothelial activation even in the abdominal space.