Platelet-to-albumin ratio helps predict mortality risk in patients undergoing peritoneal dialysis: Study

A new study published in the journal of BMC Nephrology showed that in patients receiving peritoneal dialysis (PD), the platelet-to-albumin ratio (PAR) is a separate predictor of cardiovascular disease and all-cause mortality. The long-term survival rate of patients receiving PD is still poor, despite the fact that peritoneal dialysis is an effective treatment for renal replacement. A poor prognosis for a number of illnesses is linked to the platelet-to-albumin ratio, which was recently shown to be a measure of nutritional and inflammatory conditions. Nevertheless, nothing is known about the relationship between serum PAR and the prognosis of PD patients. The purpose of this study was to assess the predictive power of PAR for cardiovascular disease (CVD) and all-cause mortality in PD patients.

Patients enduring Parkinson's disease (PD) were recruited for this multicenter cohort research between January 1, 2009, and September 30, 2018. The quartiles of the patients' baseline PAR were used to create four groups. Mortality from all causes and CVD was the main outcome. The relationship between the PAR and death from all causes or from CVD was assessed using Cox proportional hazards models. The performance of PAR and other inflammatory markers was compared using the receiver operating characteristic (ROC) curve. The incremental predictive value of PAR in comparison to the baseline model for predicting all-cause and CVD mortality was examined using the C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

The study included a total of 2825 patients, which included 747 death cases over the 47.5 ± 28.3-month follow-up period, 415 of which were due to CVD. Placement in Q4 was linked to a higher risk of both CVD and all-cause death as compared to Q1. According to the adjusted limited cubic spline analysis, there was a linear connection between the PAR and cardiovascular and all-cause mortality.

The interaction tests revealed no positive relationships. With corresponding AUC values of 0.611 for all-cause mortality and 0.609 for cardiovascular mortality, PAR demonstrated greater predictive value for death when compared to other inflammatory markers. The inclusion of PAR in the baseline model produced a moderate but substantial increase in outcome prediction, as indicated by the C-statistic, continuous NRI, and IDI. Overall, this study showed that in patients receiving PD, elevated blood PAR was strongly linked to an increased risk of death from all causes and from CVD.

Reference:

Ma, H., Chen, J., Zhan, X., Ao, S., Deng, J., Tang, R., Peng, F., Tian, N., Wen, Y., Wang, X., Feng, X., Su, N., Tang, X., Wu, X., Zhou, Q., & Xu, Q. (2024). Platelet-to-albumin ratio: a potential biomarker for predicting all-cause and cardiovascular mortality in patients undergoing peritoneal dialysis. In BMC Nephrology (Vol. 25, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12882-024-03792-8