Effect of Parathormone and Phosphate Level on Platelet Indices and Platelet Lymphocyte Ratio in End Stage Renal Disease Patients on Hemodialysis

Abstract

Background: A higher risk of death is linked to elevated levels of parathyroid hormone (PTH). Chronic kidney disease (CKD) is one of  numerous inflammatory diseases that has recently developed neutrophil lymphocyte ratio and platelet lymphocyte ratio (PLR) as  prognostic indicators. 

Objective: To determine how hemodialysis-dependent end-stage renal disease (ESRD) patients' parathormone  and phosphate levels affected platelet indices and PLR. 

Subjects and Methods: Analytical cross-sectional trial was conducted on 140  subjects aged ≥ 18 years old of both sexes. They were separated into three groups: Group I (n=100): ESRD on HD, group II (n=20): CKD  patients not on HD and group III (n=20): healthy subjects as a control group. 

Results: Mean platelet volume (MPV) was positively  correlated with CRP, total calcium, and ionized calcium. Plateletcrit (PCT) was positively correlated with sex, total leukocytic count (TLC),  absolute lymphocytes, platelets, PLR and estimated glomerular filtration rate (eGFR). Platelet distribution width (PDW) was positively  correlated with serum creatinine. PLR was positively correlated with platelets, PCT, and CRP. PCT was significantly lower in ESRD than in controls, while PDW was significantly higher in the same comparison. PDW had the largest area under the curve of ROC curve and can  discriminate ESRD from CKD and CKD from controls. 

Conclusions: Hyperphosphatemia could lower MPV and vice versa but has no effect  on other platelet indices or PLR. There was no effect of parathormone level variation on any of platelet indices or PLR. CKD can be  strongly suspected from PDW variation and fairly suspected from MPV.