The relationship of the ratio of platelet distribution width to serum albumin with kidney disease progression in patients with hypertension

Abstract Platelet distribution width (PDW), which represents the heterogeneity of platelet size, can predict a poor prognosis in various populations. However, the PDW-to-serum albumin ratio (PAR) has not been evaluated in any disease population, and whether the PAR could be a prognostic marker in hy...

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Main Authors: Kenichi Tanaka, Hiroshi Kimura, Hirotaka Saito, Michio Shimabukuro, Koichi Asahi, Tsuyoshi Watanabe, Junichiro James Kazama
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-05575-z
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author Kenichi Tanaka
Hiroshi Kimura
Hirotaka Saito
Michio Shimabukuro
Koichi Asahi
Tsuyoshi Watanabe
Junichiro James Kazama
author_facet Kenichi Tanaka
Hiroshi Kimura
Hirotaka Saito
Michio Shimabukuro
Koichi Asahi
Tsuyoshi Watanabe
Junichiro James Kazama
author_sort Kenichi Tanaka
collection DOAJ
description Abstract Platelet distribution width (PDW), which represents the heterogeneity of platelet size, can predict a poor prognosis in various populations. However, the PDW-to-serum albumin ratio (PAR) has not been evaluated in any disease population, and whether the PAR could be a prognostic marker in hypertension remains unknown. The relationship between the PAR and adverse outcomes was examined retrospectively using longitudinal data of 1,578 patients with hypertension from the Fukushima Cohort Study. Participants were categorized into tertiles by baseline PAR. The primary endpoint of the present study was a kidney event, defined as a combination of a 50% decline in eGFR from baseline and end-stage kidney disease requiring kidney replacement therapy. During the median follow-up period of 5.4 years, 146 patients had kidney events. The higher PAR group (tertile 3) showed an increased incidence of kidney events on Kaplan–Meier curve analysis. Compared with the lowest PAR tertile, the highest PAR tertile (tertile 3) showed a significantly higher risk of kidney events (adjusted hazard ratio 3.74, 95% confidence interval (CI) 1.65–8.48). Similar relationships were observed for risks of all-cause death and cardiovascular events. The predictive value of the PAR for kidney events was superior to that of PDW alone. The areas under the curves for PDW and the PAR were 0.61 (95% CI 0.56–0.66) and 0.77 (95% CI 0.74–0.81), respectively (P < 0.001). The PAR could be a useful predictive marker of adverse outcomes in this population.
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spelling doaj-art-7ba01c423f694381aaa3e459cb039eb02025-08-20T03:03:32ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-05575-zThe relationship of the ratio of platelet distribution width to serum albumin with kidney disease progression in patients with hypertensionKenichi Tanaka0Hiroshi Kimura1Hirotaka Saito2Michio Shimabukuro3Koichi Asahi4Tsuyoshi Watanabe5Junichiro James Kazama6Department of Nephrology and Hypertension, Fukushima Medical UniversityDepartment of Nephrology and Hypertension, Fukushima Medical UniversityDepartment of Nephrology and Hypertension, Fukushima Medical UniversityDivision of Advanced Community Based Care for Lifestyle Related Diseases, Fukushima Medical UniversityDivision of Advanced Community Based Care for Lifestyle Related Diseases, Fukushima Medical UniversityDivision of Advanced Community Based Care for Lifestyle Related Diseases, Fukushima Medical UniversityDepartment of Nephrology and Hypertension, Fukushima Medical UniversityAbstract Platelet distribution width (PDW), which represents the heterogeneity of platelet size, can predict a poor prognosis in various populations. However, the PDW-to-serum albumin ratio (PAR) has not been evaluated in any disease population, and whether the PAR could be a prognostic marker in hypertension remains unknown. The relationship between the PAR and adverse outcomes was examined retrospectively using longitudinal data of 1,578 patients with hypertension from the Fukushima Cohort Study. Participants were categorized into tertiles by baseline PAR. The primary endpoint of the present study was a kidney event, defined as a combination of a 50% decline in eGFR from baseline and end-stage kidney disease requiring kidney replacement therapy. During the median follow-up period of 5.4 years, 146 patients had kidney events. The higher PAR group (tertile 3) showed an increased incidence of kidney events on Kaplan–Meier curve analysis. Compared with the lowest PAR tertile, the highest PAR tertile (tertile 3) showed a significantly higher risk of kidney events (adjusted hazard ratio 3.74, 95% confidence interval (CI) 1.65–8.48). Similar relationships were observed for risks of all-cause death and cardiovascular events. The predictive value of the PAR for kidney events was superior to that of PDW alone. The areas under the curves for PDW and the PAR were 0.61 (95% CI 0.56–0.66) and 0.77 (95% CI 0.74–0.81), respectively (P < 0.001). The PAR could be a useful predictive marker of adverse outcomes in this population.https://doi.org/10.1038/s41598-025-05575-zPlatelet distribution widthHypertensionKidneyObservational studyPrognosis
spellingShingle Kenichi Tanaka
Hiroshi Kimura
Hirotaka Saito
Michio Shimabukuro
Koichi Asahi
Tsuyoshi Watanabe
Junichiro James Kazama
The relationship of the ratio of platelet distribution width to serum albumin with kidney disease progression in patients with hypertension
Scientific Reports
Platelet distribution width
Hypertension
Kidney
Observational study
Prognosis
title The relationship of the ratio of platelet distribution width to serum albumin with kidney disease progression in patients with hypertension
title_full The relationship of the ratio of platelet distribution width to serum albumin with kidney disease progression in patients with hypertension
title_fullStr The relationship of the ratio of platelet distribution width to serum albumin with kidney disease progression in patients with hypertension
title_full_unstemmed The relationship of the ratio of platelet distribution width to serum albumin with kidney disease progression in patients with hypertension
title_short The relationship of the ratio of platelet distribution width to serum albumin with kidney disease progression in patients with hypertension
title_sort relationship of the ratio of platelet distribution width to serum albumin with kidney disease progression in patients with hypertension
topic Platelet distribution width
Hypertension
Kidney
Observational study
Prognosis
url https://doi.org/10.1038/s41598-025-05575-z
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