<b>Platelets and antithrombin III in uraemia: the acute effect of haemodialysis</b>

Knudsen, Flemming; Dyerberg, Jørn

doi:10.3109/00365518509161017

Cited by 22 publications

(12 citation statements)

References 12 publications

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“…This probably represents extraction of platelets in the dialyzer since we [5] and oth ers [6] have found that platelet count is lower in the dialyzer effluent line compared to the afferent line at the very beginning of treat ment.…”

Section: Discussionmentioning

confidence: 99%

“…The change in platelet count us- ing CP membranes are, however, of such a magnitude that one would assume a clinical significance only in patients with thrombo cytopenia. Bleeding tendency in uremia is multifac torial [18], but is partly ascribed to a defect in platelet aggregation [5], Blood/surface inter actions during hemodialysis lead to further deterioration of platelet function as reflected by a decline in ADP-induced aggregation. We have previously found that platelets in the dialyzer effluent line are hypoaggregable compared with platelets in the dialyzer affer ent line and suggested that simultaneous as sessment of platelet aggregation in dialyzer inlet and outlet may serve as estimate of dia lyzer biocompatibility [5].…”

Section: Discussionmentioning

confidence: 99%

“…Ac cordingly, hemodialysis is associated with a decrease in platelet count and extraction of platelets in the dialyzer [5], a decrease in platelet aggregation [6], and an increase in circulating platelet aggregates [7], plasma thromboxane metabolites [8] and plasma beta-thromboglobulin [9], Furthermore, rise in plasma antithrombin III (AT III), which is thought to reflect release from damaged platelets or vascular endothelial cells, has been reported during hemodialysis [10]. The development of biologically inert dialyzer membranes that do not activate the coagula tion system or cause platelet damage is there fore of great interest.…”

Section: Introductionmentioning

confidence: 99%

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Polycarbonate versus Cuprophan Dialyzers: Effect on Platelet Function

Knudsen¹,

Nielsen²

1984

Blood Purif

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Despite the use of various modalities of heparinization, bleeding episodes constitute a treat during hemodialysis in high-risk patients. The bleeding tendency may not only be due to the effect of heparin per se, but also reflect platelet injury elicited by interaction between platelets and foreign surfaces in the extracorporeal circuit. Accordingly, decline in platelet count, extraction of platelets in the dialyzer, decrease in platelet aggregation and increase in plasma levels of beta-thromboglobulin and antithrombin III (AT III) attend hemodialysis. In the present study, 12 patients were studied during two successive dialyses using membranes based on cuprophan (CP) and polycarbonate (PC). Indicating extraction of platelets in the dialyzer, hemodialysis with CP membranes induced a decline in platelet count during the 1 st h of treatment. The platelet count was, however, unchanged during dialysis with PC membranes. Irrespective of the membrane material, hemodialysis was associated with platelet injury as reflected by intradialytic deterioration of platelet aggregation and rise in plasma beta-thromboglobulin. Both immunological AT III and AT III activity were unchanged during dialysis. The results stress the need for continued search for biologically inert dialyzer membrane materials.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Polycarbonate versus Cuprophan Dialyzers: Effect on Platelet Function

Knudsen¹,

Nielsen²

1984

Blood Purif

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“…In this respect, we had to exclude dialysis patients because of their complicated hemostatic system [13][14][15][16][17][18] and we also had to adopt hemostastatic markers that are not affected by renal elimination. Both TAT and D-dimer are known to have high molecular weights, so excretion of these markers from the kidney is very limited.…”

Section: Discussionmentioning

confidence: 99%

Impact of Decreased Renal Function on Coagulation and Fibrinolysis in Patients With Non-Valvular Atrial Fibrillation

Tanaka

Sonoda

Kashima

et al. 2009

Circ J

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Background:The prothrombotic state in non-valvular atrial fibrillation (NVAF) increases the risk of thromboembolic events. It is also well known that a prothrombotic state exists in renal failure. Hemostatic disorders play a role in thromboembolic mortality in both NVAF and renal failure. However, little is known about the influence of renal function on hemostasis in patients with NVAF. Methods and Results: A total of 190 consecutive outpatients with NVAF who were not receiving anticoagulant therapy were enrolled in the present study. Patients were stratified in groups based on estimated glomerular filtration rate (eGFR). Plasma concentrations of thrombin-antithrombin complex (TAT) and D-dimer were measured and the influence of renal function on coagulation and fibrinolysis was assessed. A relatively weak and inverse relationship of eGFR to TAT and D-dimer was observed (r=0.28, P=0.0001; r=0.30, P<0.0001). Both mean TAT and D-dimer concentrations in groups gradually and significantly increased as eGFR decreased (P<0.0001). On multivariate regression analysis, decreased eGFR concentration was a significant predictor for elevation of TAT (P<0.05) and D-dimer (P<0.01) in patients with NVAF. Conclusions:The enhanced coagulation activation appeared to be related to a reduction in residual renal function in patients with NVAF. This suggests that decreased renal function might be a candidate predictor of thromboembolic events in patients with NVAF. (Circ J 2009; 73: 846 -850)

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“…Plate lets returning to the patient are reduced in number and hypoaggregable. Consequently, systemic platelet count and aggregation de creases during the treatment [1,9], In the present study, CP membranes induced a de crease in platelet count during hemodialysis, whereas the platelet count was unchanged with PC membranes. This finding could indi cate lower or absent extraction of platelets with PC membranes.…”

Section: Discussionmentioning

confidence: 79%

Biocompatibility of a New Polycarbonate Dialysis Membrane

Knudsen¹,

Nielsen²,

Pedersen³

et al. 1986

Blood Purif

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The present report summarizes our experience with a new polycarbonate (PC)- based dialysis membrane (Gambro Lundia® PRO-5) compared with a cuprophan (CP)-based membrane (Gambro Lundia® 10-5N).Platelet count decreased during dialysis with CP, but was unchanged with PC membranes. Platelet injury, reflected by decreased platelet aggregation and increase in plasma β-thrombo-globulin, occurred equally with both membranes. Complement activation (C3d and C5a), leukopenia and release of granulocyte-derived elastase was more extensive with CP than with PC membranes. The new membrane represents an improvement of biocompatibility with respect to the complement-leukocyte system, whereas the effect on platelets resembles the injury caused by CP membranes.

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Platelets and antithrombin III in uraemia: the acute effect of haemodialysis

Cited by 22 publications

References 12 publications

Polycarbonate versus Cuprophan Dialyzers: Effect on Platelet Function

Polycarbonate versus Cuprophan Dialyzers: Effect on Platelet Function

Impact of Decreased Renal Function on Coagulation and Fibrinolysis in Patients With Non-Valvular Atrial Fibrillation

Biocompatibility of a New Polycarbonate Dialysis Membrane

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