Published: 2016-12-29

A comparative study of platelet parameters in end stage renal disease patients undergoing haemodialysis and healthy individuals

Lokesh S., Siva Ranganathan Green, Tony Kadavanu Mathew, Hemachandar R., Arun Kumar, Shashank Rakesh Tiwari, Amirtha Lakshmi, Ezhumalai G.


Background: With the rising trend of diabetes mellitus and hypertension in developing countries like India, there is also a rise in chronic complications like end stage renal disease (ESRD). ESRD poses a huge financial burden on family and health care sector due to a high morbidity and mortality associated with it. Cardiovascular complications remain the most common cause of death among ESRD patients and those undergoing hemodialysis (HD). Hemodialysis patients behave in a distinct way that they are relatively more prone for bleeding than thrombotic manifestations. In recent days abnormalities in platelet parameters are found to be an effective tool in risk stratification of patients with chronic kidney disease (CKD) to develop coronary artery disease. Due to scarcity of literature especially from India, the present study was taken to find the association of various platelet parameters among hemodialysis patients. The aim was to study the platelet distribution width (PDW), mean platelet volume, platelet count, plateletcrit and platelet large cell ratio (PLCR) among ESRD patients undergoing maintenance hemodialysis and compare with healthy age and sex matched controls.

Methods: The present study was done on two groups. Group A (Cases) consisting of 40 ESRD patients receiving HD for more than 6 months, and group B (controls) consisting of 40 healthy controls from hospital staffs and healthy volunteers matched for age and sex.

Results: The mean values of platelet distribution width (PDW), mean platelet volume, platelet count, plateletcrit and platelet large cell ratio (PLCR) were found to be lower in cases when compared to healthy controls. PDW, platelet count and plateletcrit attained statistical significance, while others did not.

Conclusions: Abnormality in platelet parameter to assess CVD risk may be applicable in general population as well as in CKD patients, but its role in hemodialysis patient’s further need to be evaluated.


Chronic kidney disease, Hemodialysis, Coronary artery disease, Cerebrovascular disease, Platelet distribution width, Mean platelet volume, Platelet large cell ratio

Full Text:



Pal R, Bagarhatta R, Gulati S, Rathore M, Sharma N. Mean platelet volume in patients with acute coronary syndromes: a supportive diagnostic predictor. J Clinical Diagnostic Res. 2014;8(8):1-4.

Murat S, Duran M, Kalay N, Gunebakmaz O, Akpek M, Doger C et al. Relation between mean platelet volume and severity of atherosclerosis in patients with acute coronary syndromes. Angiology. 2012;64(2):131-6.

Schoorl M, Nube M, Bartels P. Platelet depletion, platelet activation and coagulation during treatment with hemodialysis. Scandinavian J Clinical Lab Investigation. 2011;71(3):240-7.

Schoorl M, Bartels P. Changes in platelet volume, morphology and RNA content in subjects treated with haemodialysis. Scandinavian Journal of Clinical and Laboratory Investigation. 2008;68(4):335-42.

Koroglu M, Akalin N, Ozkan H, Harmankaya O. Importance of platelet markers for demonstrating the presence of inflammation in different stages of chronic renal diseases. Eur J Basic Med Sci. 2015;5(1):1-9.

Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution widty: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010;14(1):28-32.

Bessman JD, Gilmer PR, Gardner FH. Use of mean platelet volume improves detection of platelet disorders. Blood Cells. 1985;11:127-35.

Rafieian KM, Nasri H. Platelet counts and mean platelet volume in association with serum magnesium in maintenance hemodialysis patients. J Renal Injury Prevention. 2012;1(1):17-21.

Ando M, Iwamoto Y, Suda A, Tsuchiya K, Nihei H. New insight in to the thrombopoietic status of patients on dialysis through evaluation of megakaryocytopoiesis in bone marrow and endogenous thrombopoietin levels. Blood. 2001;97:915-21.

Alghythan AK, Alsaeed AH. Hematological changes before and after hemodialysis. Sci Research Essays. 2012;7(4):490-7.

Babu E, Basu D. Platelet large cell ratio in the differential diagnosis of abnormal platelet counts. Indian J Pathol Microbiol. 2004;47(2):202-5.