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The following is a summary of “Platelet-to-albumin ratio: a potential biomarker for predicting all-cause and cardiovascular mortality in patients undergoing peritoneal dialysis,” published in the October 2024 issue of Nephrology by Ma et al.
Peritoneal dialysis (PD) is an effective renal replacement therapy, but patients undergoing PD have low long-term survival rates. The platelet-to-albumin ratio (PAR), an indicator of inflammation and nutrition, may be linked to poorer outcomes, though its role in predicting prognosis for these patients is not well understood.
Researchers conducted a retrospective study to assess whether the PAR predicts CVD and all-cause mortality in patients undergoing PD.
They conducted a multicenter cohort study from January 1, 2009, to September 30, 2018, dividing patients undergoing PD into quartiles based on baseline PAR. Cox models assessed the link between PAR and mortality, while ROC curves, C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) evaluated PAR’s prognostic value. (C-statistic, NRI, IDI).
The results showed that 2,825 patients were included, with 747 deaths (26.4%) during the 47.5 ± 28.3 month follow-up, of which 415 (55.6%) were CVD-related. Compared to Q1 (PAR < 4.43), patients in Q4 (PAR > 7.27) had a higher risk of all-cause and CVD mortality (P < 0.001). Adjusted restricted cubic spline analysis demonstrated a linear relationship between PAR and both mortality outcomes (P for nonlinearity = 0.289 and 0.422, respectively), with no significant interactions. PAR had a higher predictive value for mortality than other inflammatory markers, with AUC values of 0.611 (P < 0.001) for all-cause and 0.609 (P < 0.001) for CVD mortality. The addition of PAR to the baseline model improved outcome prediction according to C-statistic, continuous NRI, and IDI. (C-statistic, NRI, IDI).
The study concluded that the PAR is an independent prognostic factor for predicting all-cause and cardiovascular mortality in patients undergoing PD.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03792-8#Abs1