Compared to healthy controls, mean platelet volume (MPV) is frequently higher in patients with Familial Mediterranean fever (FMF) but lower in AA amyloidosis patients. The reason for the difference in MPV levels in FMF patients with and without AA amyloidosis is unclear. The aim of the study was to determine whether low MPV is unique to AA amyloidosis or MPV is similarly low in all glomerular diseases as a result of proteinuria and/or renal dysfunction. We compared pre-biopsy MPV levels of patients with AA amyloidosis secondary to FMF, to MPV levels of patients with membranous glomerulonephritis, focal segmental glomerulosclerosis (FSGS) and IgA nephropathy that all present with proteinuria and renal dysfunction. 703 patients (411 male, 292 female) were included in the study. Mean age was 42.6?14.3 years. There were 124 patients with AA amyloidosis, 224 patients with IgA nephropathy, 188 patients with membranous glomerulonephritis and 167 patients with FSGS. Patients with AA amyloidosis had lower MPV levels compared to patients without AA amyloidosis (7.9?1.2 fL vs. 8.2?0.9 fL respectively, p=0.008). Patients with AA amyloidosis had significantly lower MPV compared to patients with each of the other diagnoses. Independent predictors of MPV were platelet count (ß= - 0.321, p < 0.001) and CRP (ß= - 0.134, p < 0.03). This study is the largest study of MPV in patients with biopsy proven AA amyloidosis and confirms previous studies reporting low MPV in AA amyloidosis. This study indicates that low MPV in AA amyloidosis cannot be explained with proteinuria and renal dysfunction.

Background and Objectives: Acute methanol intoxication is characterized by metabolic acidosis, neurotoxicity, acute kidney injury (AKI), and mortality. Although systemic inflammatory indices have been proposed as prognostic markers, their independent prognostic role beyond established severity markers remains uncertain. We evaluated whether admission inflammatory indices were independently associated with in-hospital mortality and AKI at admission and derived an exploratory Methanol Acute Injury Score (MAIS-4). Materials and Methods: This retrospective cohort included 86 patients with probable acute methanol poisoning. Admission inflammatory indices and exploratory creatinine-derived eGFR trajectories were evaluated. Multivariable logistic regression assessed adjusted associations with creatinine-defined AKI according to KDIGO criteria at admission and in-hospital mortality. MAIS-4 was evaluated by ROC analysis and bootstrap optimism correction of the fixed-category Firth model. Results: The cohort was predominantly male (93.0%); median age was 54.5 years. In-hospital mortality occurred in 47 patients (54.7%), and AKI was present at admission in 60 patients (69.8%). In unadjusted analyses, NLR, PLR, SII and SIRI were lower in non-survivors, and PLR was lower in patients with admission AKI. No independent association was detected for any index after adjustment. In adjusted analyses, lower Glascow Coma Scale scores were associated with mortality and lower arterial pH with AKI at admission. Among survivors, 30.8% had a final creatinine-derived eGFR below the documented baseline. MAIS-4, incorporating Glasgow Coma Scale score, arterial pH, serum albumin, and admission AKI, showed an apparent AUC of 0.938 for mortality (optimism-corrected AUC of the fixed-category Firth model, 0.919) with 76.6% sensitivity and 94.9% specificity at ≥5 points. Conclusions: No independent association of admission inflammatory indices with in-hospital mortality or AKI at admission was detected after adjustment for core metabolic and neurological severity markers. MAIS-4 is an exploratory derivation score that requires external validation.

Background and Objectives: Anemia is a frequent complication of chronic kidney disease (CKD), primarily attributed to erythropoietin deficiency. Interstitial fibrosis (IF), which disrupts the renal interstitium where erythropoietin-producing cells reside, may contribute to anemia independent of glomerular filtration rate (GFR). However, data in primary glomerulonephritis (PGN) are limited and conflicting. Materials and Methods: In this nationwide multicenter registry analysis (TSN-GOLD), 2794 adults with biopsy-proven PGN were included. Interstitial fibrosis was graded semi quantitatively (0–3). Anemia was defined according to KDIGO/WHO criteria. Multivariable logistic regression models were constructed to evaluate the independent association between IF severity and anemia, adjusting for age, sex, eGFR, log-transformed proteinuria, hypertension, diabetes mellitus, and biopsy diagnosis. Interaction between IF and eGFR was assessed. A predefined subgroup analysis was performed in patients with preserved renal function (eGFR ≥ 60 mL/min/1.73 m²). Results: Anemia was present in 34.4% of patients. Although moderate-to-severe IF was more frequent among anemic patients (p < 0.001), IF severity was not independently associated with anemia in multivariable analysis (p-trend = 0.72). Female sex and lower eGFR were independently associated with anemia. A statistically significant IF×eGFR interaction was observed (p = 0.0029), indicating effect modification across renal function levels. The model demonstrated moderate discrimination (AUC = 0.705). In patients with preserved renal function, IF severity was not associated with anemia. Conclusions: In this large multicenter cohort of PGN patients, interstitial fibrosis severity was not independently associated with anemia after adjustment for renal function and clinical covariates. These findings suggest that the association between interstitial fibrosis and anemia in PGN appears largely mediated by renal functional status rather than fibrosis severity alone.