Abstract:

ABSTRACT Objective: A retrospective analysis was made to investigate the incidence of platelet decline and related risk factors in patients receiving CRRT. Methodology: From November 2008 to October 2012, all patients receiving continuous veno-venous hemofiltration (CVVH) in Jinling hospital were screened，Only patients matching following criteria were enrolled for further analysis: uninterrupted CVVH for more than 72h, with records of blood test for consecutive four days, ruling out pre-existing conditions maybe affecting platelet counts. The levels of platelet were counted before and during CVVH, and the illness severity, and outcome were also analyzed at the same time. Results：They were 125 patients, 97 males and 28 females, with a mean age of 51.8±18.7 years. The mean APACHE II score was 17.8±6.5. During three-day CVVH, 60.8% patients had a decline of platelet count more than 20%, and 16% patients had a decline more than 50%; the percentage of thrombocytopenia (Plt≤100×109/L) and severe thrombocytopenia (Plt≤50×109/L) was 53.6% and 16.0%, respectively. There were no differences of mean platelet volume (MPV) between before CVVH and during CVVH. The patients with platelet decline more than 50% had a significantly lower survival rate than others (35.0% versus 59.0%, P=0.012), while patients with severe thrombocytopenia had a survival rate similar with others (45.0% versus 57.1%, P=0.308). Female gender, older age and longer course of the disease were independent risk factors of platelet decline more than 50%, and thrombocytopenia before CVVH was the independent risk factor of severe thrombocytopenia after CVVH. Conclusions：Platelet decline and thrombocytopenia are quite common in patients receiving CVVH. The extent of platelet decline rather than absolute count during CVVH may affect survival rate. The risk factors of platelet decline more than 50% included female gender, older age and longer course of the disease.

Key words:  Platelet decline,  thrombocytopenia, continuous veno-venous hemofiltration, incidence, risk factors