Predictive value of platelet indices in children with idiopathic nephrotic syndrome

Azar Nickavar,Sahar Sadr Moharerpour,Ehsan Abiry

doi:10.15171/ipp.2020.04

Azar Nickavar, Sahar Sadr Moharerpour + Show 1 more

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https://doi.org/10.15171/ipp.2020.04

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Abstract

Introduction: Different biomarkers have been investigated for prognosis of patients with nephrotic syndrome. Qualitative and quantitative changes have been reported in platelets in these patients. Objectives: The aim of this study was to identify platelet abnormalities and their prognostic value of steroid response in children with idiopathic nephrotic syndrome. Patients and Methods: Platelet counts and indices (mean platelet volume [MPV], platelet distribution width [PDW] and platelet larger cell ratio [PLCR]) were evaluated and compared in 122 children with active nephrotic syndrome (64%; steroid resistant and 36%; steroid sensitive). Results: Mean age at diagnosis was 55 months (6 to169 months), and males outnumbered females (1.7/1). Steroid resistant patients had significantly higher platelet counts and lower PLCR, compared to steroid sensitive group. Regarding area under the ROC curve, low MPV, high PDW and low PLCR showed relatively acceptable correlation with steroid resistance. Conclusion: Increased platelet counts in addition to low PLCR are the suggestive indicators of steroid resistance in children with idiopathic nephrotic syndrome.

Highlights

Different biomarkers have been investigated for prognosis of patients with nephrotic syndrome
In a study on 122 children with active nephrotic syndrome (64%; steroid resistant and 36%; steroid sensitive), we found that steroid resistant patients had significantly higher platelet counts and lower platelet larger cell ratio compared to steroid sensitive group
SR children had significantly higher platelet counts, lower platelet large cell ratio (PLCR) and higher triglyceride level compared to the SS group

Summary

Introduction

Different biomarkers have been investigated for prognosis of patients with nephrotic syndrome. Patients and Methods: Platelet counts and indices (mean platelet volume [MPV], platelet distribution width [PDW] and platelet larger cell ratio [PLCR]) were evaluated and compared in 122 children with active nephrotic syndrome (64%; steroid resistant and 36%; steroid sensitive). Conclusion: Increased platelet counts in addition to low PLCR are the suggestive indicators of steroid resistance in children with idiopathic nephrotic syndrome. Platelets play an essential role in primary hemostasis They are important mediators of immunomodulation and inflammatory reactions by releasing different cytokines and growth factors (1,2). Quantitative and qualitative changes in platelet characteristics such as mean platelet volume (MPV) and platelet counts, in addition to platelet activation and increased surface expression of activation-dependent platelet markers, have been suggested as potential predictive markers of different inflammatory disorders, including nephrotic syndrome. Activation and release of inflammatory mediators, with increased coagulability and thrombus formation might influence the process of nephrotic syndrome (2-4)

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