In reply: Uncertainties in the relationship between high mean platelet volume and acute kidney injury after cardiac surg
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CORRESPONDENCE
In reply: Uncertainties in the relationship between high mean platelet volume and acute kidney injury after cardiac surgery Abinaya Ramakrishnan . Cynthia Zheng, BA . Manuel L. Fontes, MD . Frederic W. Lombard, MBChB, FANZCA . Austin A. Woolard, MD . Yaping Shi, MS . Matthew S. Shotwell, PhD . Frederic T. Billings 4th, MD . Mias Pretorius, MBChB, MSCI . Jonathan P. Wanderer, MD, MPhil, FASA, FAMIA . Rushikesh Vyas, MD . Tarek S. Absi, MD . Ashish S. Shah, MD . Miklos D. Kertai, MD, PhD Received: 5 October 2020 / Revised: 5 October 2020 / Accepted: 8 October 2020 Ó Canadian Anesthesiologists’ Society 2020
To the Editor, First, we express our gratitude for the interest of Drs Beyan1 in our recent publication in the Journal, ‘‘Mean platelet volume and cardiac-surgery-associated acute kidney injury: a retrospective study.’’2 In their letter, Drs Beyan indicated that ‘‘there is no standardized method to measure mean platelet volume (MPV), raising the question of whether MPV values should be used for purposes of making diagnoses or defining prognosis in patients with acquired diseases.’’1 We specifically stated in our limitation section that ‘‘The reference range for normal MPV values used in our study was based on the definition set by the Vanderbilt Clinical Pathology Laboratory’’.2 Nevertheless, this definition of a normal reference range is slightly different from that used in other studies, and it was
not specifically reported for male and female patients separately.3 Furthermore, there is evidence that normal reference intervals recommended by different manufacturers of hematological analyzers could be different, and thus, laboratories often develop their own normal reference ranges. Our hospital laboratory has been measuring and reporting MPV for almost a decade. Indeed, for our institution a ‘‘standard’’ exists for measuring MPV. We agree that laboratory testing can be associated with varying errors affecting sensitivity and specificity. Nevertheless, both subjects with postoperative acute kidney injury (AKI) and those without AKI would have suffered from similar measurement challenges as indicated by Drs Beyan. We are not the first to report on the relation between MPV and ischemic outcomes (e.g., AKI, graft closure, mortality).4 In our discussion, we described ‘‘a nonlinear relationship between platelets count and MPV values’’.2
This reply is related to letter https://doi.org/10.1007/s12630-02001835-w. A. Ramakrishnan Vanderbilt University, Nashville, TN, USA
Y. Shi, MS M. S. Shotwell, PhD Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
C. Zheng, BA Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
J. P. Wanderer, MD, MPhil, FASA, FAMIA Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
M. L. Fontes, MD Yale School of Medicine, New Haven, CT, USA
Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
F. W. Lombard, MBChB, FANZCA A. A. Woolard, MD F. T. B
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