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Saudi Journal of Kidney Diseases and Transplantation
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Year : 2016  |  Volume : 27  |  Issue : 4  |  Page : 836-838
The relationship between inflammation, blood pressure, and mean platelet volume in chronic kidney disease

1 Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
2 Department of Biostatistics, Faculty of Medicine, Cukurova University, Adana, Turkey

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Date of Web Publication5-Jul-2016

How to cite this article:
Altun E, Paydas S, Kaya B, Seydaogulları G. The relationship between inflammation, blood pressure, and mean platelet volume in chronic kidney disease. Saudi J Kidney Dis Transpl 2016;27:836-8

How to cite this URL:
Altun E, Paydas S, Kaya B, Seydaogulları G. The relationship between inflammation, blood pressure, and mean platelet volume in chronic kidney disease. Saudi J Kidney Dis Transpl [serial online] 2016 [cited 2022 Sep 29];27:836-8. Available from: https://www.sjkdt.org/text.asp?2016/27/4/836/185291
To the Editor,

The relationship between mean platelet volume (MPV) and coronary artery disease, atherosclerotic vascular pathologies, and platelet aggregation is not well established. [1],[2] Platelet activation in patients with chronic kidney disease (CKD) may contribute to cardiovascular mortality. [3] Inflammatory markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, and interleukin IL-10 and IL-6 are also indicators for cardiovascular disease in patients with CKD. We did a study to investigate the relationship between MPV and inflammatory markers, blood pressure and comorbidities in patients undergoing renal replacement therapy.

The study was performed on 20 hemodialysis patients (HD), 20 continuous ambulatory peritoneal dialysis patients (PD), 23 kidney transplant recipients (KTrs), and 25 healthy subjects (control). Patients with acute infection, malignant disease, active heart failure, fluid-electrolyte imbalance or any other acute problem were excluded. Diabetes mellitus (DM), coronary artery disease (CAD), and hypertension were recorded as comorbid conditions (Go = No comorbid condition, G1 = patients with hypertension, G2 = patients with hypertension, DM, and coronary arterial disease). Physical examination findings and blood pressure measurements were recorded. Ambulatory blood pressure (ABP) was measured at least 27 h. Complete blood count, ESR, CRP, ferritin, and IL-1 and IL-6 levels were measured on the ABP day. Blood samples were obtained for the measurement of platelet and MPV. MPV was measured using the method of electrical impedance and coulter LH 780 automatic analyzer (Miami/USA Beckmann coulter).

The demographic and clinic features of all patients are summarized in [Table 1]. Statistically significant correlations were found between MPV and office blood pressure; daytime systolic blood pressure (SBP) and daytime diastolic blood pressure (DBP) in HD and PD patients; however, MPV correlated only with nighttime SBP and nighttime DBP in KTrs. The mean values of IL-6, IL-10, ESR, ferritin, and MPV were found significantly higher in the presence of comorbid conditions.
Table 1: Demographic and clinical features of patients.

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Hypertension is an important risk factor for heart attack, stroke and other vascular diseases. [4],[5] Nadar et al [6] reported that MPV in hypertensive patients was higher than that of the normotensive subjects. MPV was found elevated in gestational hypertensive patients according to normotensive pregnant. [7] In our study, we found a significant correlation between MPV and blood pressure in all three patient groups receiving renal replacement therapy. Kaya et al [8] found more increased CRP and higher MPV in non-dipper patients rather than dipper group.

Moreover, MPV significantly correlated with CRP levels. Guven et al [9] reported that elevated MPV values positively correlated with higher CRP in masked hypertensive patients. On the other hand, in our study, there was no correlation between CRP and blood pressure in patient groups treated with renal replacement therapy groups.

Vascular complications are known as a result of endothelial damage and thrombosis. [10] In various studies, elevated thrombocyte volume was specified as an independent risk factor for cardiovascular diseases in diabetic and hyper-lipidemic patients. [11] MPV was significantly higher in our patients with comorbid situations such as hypertension and diabetes mellitus compared with those without comorbid conditions.

Thrombocyte abnormalities in dialysis patients are due to activation and consumption of thrombocytes during their contact with dialysis membranes, and only small thrombocytes survive in circulation. [12],[13] In our study, PD patients had lower MPV but nonsignificantly. Ju et al [14] found that glomerular filtration rate negatively correlated with MPV.

In conclusion, MPV was not elevated in patients with CKD and healthy control groups, but MPV, ESR and ferritin were significantly higher in patients undergoing renal replacement therapy with co-morbid conditions including DM, hypertension, and CAD compared with those without comorbid conditions. IL-6, IL-10, CRP and MPV levels were not significantly different in HD patients, PD patients, KTrs, and healthy controls. MPV positively correlated with blood pressure in all RRT groups and healthy controls. We cannot say that MPV as a noninvasive test can be beneficial for the assessment of cardiovascular risk in CKD.

Conflict of interest: None declared.

   References Top

Chu SG, Becker RC, Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: A systematic review and meta-analysis. J Thromb Haemost 2010;8:148-56.  Back to cited text no. 1
De Luca G, Santagostino M, Secco GG, et al. Mean platelet volume and the extent of coronary artery disease: Results from a large prospective study. Atherosclerosis 2009;206:292-7.  Back to cited text no. 2
Bilen Y, Cankaya E, Keles M, et al. Does decreased mean platelet volume predict inflammation in chronic renal failure, dialysis, and transplanted patients? Ren Fail 2014;36:69-72.  Back to cited text no. 3
Joint National Committee. The seventh report of the Joint National Committee on detection, evaluation and treatment of high blood pressure (JNC 7). J Am Med Assoc 2003;289:2560-72.  Back to cited text no. 4
Kannel WB. Blood pressure as a cardiovascular risk factor: Prevention and treatment. JAMA 1996;275:1571-6.  Back to cited text no. 5
Nadar SK, Blann AD, Kamath S, Beevers DG, Lip GY. Platelet indexes in relation to target organ damage in high-risk hypertensive patients: A substudy of the anglo-scandinavian cardiac outcomes trial (ASCOT). J Am Coll Cardiol 2004;44:415-22.  Back to cited text no. 6
Giles C, Inglis TC. Thrombocytopenia and macrothrombocytosis in gestational hypertension. Br J Obstet Gynaecol 1981;88:1115-9.  Back to cited text no. 7
Kaya MG, Yarlioglues M, Gunebakmaz O, et al. Platelet activation and inflammatory response in patients with non-dipper hypertension. Atherosclerosis 2010;209:278-82.  Back to cited text no. 8
Guven A, Caliskan M, Ciftci O, Barutcu I. Increased platelet activation and inflammatory response in patients with masked hypertension. Blood Coagul Fibrinolysis 2013;24:170-4.  Back to cited text no. 9
Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link between thrombosis and inflammation? Curr Pharm Des 2011;17:47-58.  Back to cited text no. 10
Varol E, Ozaydin M. Mean platelet volume as a surrogate marker of inflammation in systemic lupus erythematosus. Clin Rheumatol 2014;33:1691-2.  Back to cited text no. 11
Boccardo P, Remuzzi G, Galbusera M. Platelet dysfunction in renal failure. Semin Thromb Hemost 2004;30:579-89.  Back to cited text no. 12
Kaw D, Malhotra D. Platelet dysfunction and end-stage renal disease. Semin Dial 2006;19:317-22.  Back to cited text no. 13
Ju HY, Kim JK, Hur SM, et al. Could mean platelet volume be a promising biomarker of progression of chronic kidney disease? Platelets 2015;26:143-7.  Back to cited text no. 14

Correspondence Address:
Dr. Saime Paydas
Department of Nephrology, Faculty of Medicine, Cukurova University, Adana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-2442.185291

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