Effect of Parathormone and Phosphate Level on Platelet Indices and Platelet Lymphocyte Ratio in End Stage Renal Disease Patients on Hemodialysis

Background: A higher risk of death is linked to elevated levels of parathyroid hormone (PTH). Chronic kidney disease (CKD) is one of numerous inflammatory diseases that has recently developed neutrophil lymphocyte ratio and platelet lymphocyte ratio (PLR) as prognostic indicators. Objective: To determine how hemodialysis-dependent end-stage renal disease (ESRD) patients' parathormone and phosphate levels affected platelet indices and PLR. Subjects and Methods: Analytical cross-sectional trial was conducted on 140 subjects aged ≥ 18 years old of both sexes. They were separated into three groups: Group I (n=100): ESRD on HD, group II (n=20): CKD patients not on HD and group III (n=20): healthy subjects as a control group. Results: Mean platelet volume (MPV) was positively correlated with CRP, total calcium, and ionized calcium. Plateletcrit (PCT) was positively correlated with sex, total leukocytic count (TLC), absolute lymphocytes, platelets, PLR and estimated glomerular filtration rate (eGFR). Platelet distribution width (PDW) was positively correlated with serum creatinine. PLR was positively correlated with platelets, PCT, and CRP. PCT was significantly lower in ESRD than in controls, while PDW was significantly higher in the same comparison. PDW had the largest area under the curve of ROC curve and can discriminate ESRD from CKD and CKD from controls. Conclusions: Hyperphosphatemia could lower MPV and vice versa but has no effect on other platelet indices or PLR. There was no effect of parathormone level variation on any of platelet indices or PLR. CKD can be strongly suspected from PDW variation and fairly suspected from MPV.