Platelet Parameters as Indicators of Arteriovenous Fistula Thrombosis in Hemodialysis Patients

Background: The total number of platelets (PLT), plateletcrit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW) are utilized as markers of platelet activation in assessing thrombotic vascular events. Given the critical importance of maintaining adequate vascular access, i.e., arteriovenous (AV) fistula, for the survival of hemodialysis (HD) patients, the question arises: Is it possible to detect changes in platelet parameters that indicate a connection to occurrences of thrombotic complications with AV fistula?

Materials and methods: The study involved 100 patients diagnosed with end-stace renal disease, admitted to the Clinic of Hemodialysis at the University Clinical Center Sarajevo (UCCS). All patients underwent standard bicarbonate HD three times a week, utilizing a native AV fistula for access. The study group was divided into two subgroups: patients without confirmed AV fistula thmmbosis (AVF-nonT; n = 66) and patients with confirmed AV fistula thrombosis (AVF-T; n = 34). Anamnestic data and platelet parameter values were collected during the surveyed period.

Results: The average value of the PLT was significantly lower (p = 0.001), while the average value of the MPV was significantly higher (p = 0.0001) in patients of the AVF-T group in relation to the patients in the AVF-nonT group. In differentiating patients of the AVF-T group and patients of the AVF-nonT group, PLT in peripheral blood had a moderately good diagnostic accuracy (AUC = 0.704; p = 0.001), and MPV had an excellent diagnostic accuracy (AUC = 0.991; p < 0.001).

Conclusion: PLT and MPV can be used as effective biomarkers ofAV fistula thrombosis in patients undergoing chronic HD treatment.