Biphasic effects of hemodialysis on platelet reactivity in patients with end-stage renal disease: A potential contributor to cardiovascular risk

Aggarwal, Atul; Kabbani, Samer; Rimmer, Jeffery M.; Gennari, F. John; Taatjes, Douglas J.; Sobel, Burton E.; Schneider, David J.

doi:10.1053/ajkd.2002.34510

Cited by 62 publications

(50 citation statements)

References 26 publications

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“…The artifi cial circuit, changed rheology, and heparin might activate platelets [4,5,17,19] . These effects could be counterbalanced by defective aggregation of platelets due to end-stage renal disease [15] . In the literature, contradictory results have All values are medians with ranges between the fi rst and the third quartiles.…”

Section: Discussionmentioning

confidence: 99%

“…HD = Haemodialysis; NS = not signifi cant. been reported in regard to the effect of haemodialysis on platelet aggregation, probably related to the complex interaction of the vessel wall, changes in rheology, and different compositions of the dialysis circuit and anticoagulants on platelet function [4,5,15,17,19,[22][23][24] . Overall, our results did not show differences in platelet aggregation before and immediately after haemodialysis procedure, suggesting that the haemodialysis procedure probably does not signifi cantly activate platelets.…”

Section: Discussionmentioning

confidence: 99%

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The Influence of the Haemodialysis Procedure on Platelets, Coagulation and Fibrinolysis

Šabovič¹,

Salobir²,

Zupan³

et al. 2005

Pathophysiol Haemos Thromb

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In end-stage renal disease, in particularly when treated with haemodialysis, the function of platelets, coagulation and fibrinolytic systems can be disturbed, thus contributing to either thrombotic or bleeding complications. It is important to know whether the currently used haemodialysis procedure itself (by biocompatible membranes and better anticoagulation with nandroparin) affects platelets, coagulation or fibrinolysis. In 15 patients who had been treated with chronic haemodialysis, we measured and compared platelet aggregation (induced by adenosine diphosphate, collagen and epinephrine), the markers of coagulation and fibrinolysis activation (thrombin-antithrombin complexes, thrombin fragments F1+2, D-dimer), and fibrinolytic parameters, i.e. fibrinogen, plasminogen, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 1 antigen and activity, before and immediately after the regular haemodialysis sessions. We did not find differences between pre- and post-haemodialysis platelet aggregation induced with all agents. Markers of coagulation and fibrinolysis activation remained unchanged during the process of haemodialysis. However, in post-haemodialysis samples, t-PA activity was significantly increased. Other fibrinolytic parameters remained unchanged. In conclusion, our results showed that the current technique of haemodialysis procedure does not affect platelet aggregation or activate coagulation, and therefore, does not contribute to a thrombotic tendency. However, it does directly affect fibrinolysis through activation of t-PA, which might be clinically relevant since this could increase the bleeding tendency in some haemodialysis patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Influence of the Haemodialysis Procedure on Platelets, Coagulation and Fibrinolysis

Šabovič¹,

Salobir²,

Zupan³

et al. 2005

Pathophysiol Haemos Thromb

View full text Add to dashboard Cite

show abstract

“…It has also been shown that, in addition to these baseline abnormalities, platelet reactivity and aggregation are altered throughout the course of a dialysis session, with similar increases in reactivity as seen in patients with coronary artery disease 25 .…”

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confidence: 90%

The role of platelets in the prognosis of renal disease

Forbes¹,

Ashman²,

Yaqoob³

2013

OA Nephrology

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IntroductionPlatelets were first discovered in 1842, identified as 'little globules' or 'granular masses'. Since then, our understanding of these small nonnucleated cells has massively increased, and over the years the humble platelet has been found to be a critical player in many physiological processes. Here, we explore the role of platelets in patients with renal diseases and examine their significance in outcomes. ConclusionIt is clear that, far from being mere 'particles in the blood', platelets are remarkable and exciting cells that have highly evolved and intricate functions spanning far beyond just haemostasis, encompassing many other physiological processes.

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“…Stroke patients with ESRD are at a disadvantage for IV rt-PA for several reasons [7,8,9]. First, advanced diabetes, which is known to be associated with poor outcome after IV rt-PA, is frequent in ESRD patients.…”

Section: Discussionmentioning

confidence: 99%

Intravenous Recombinant Tissue Plasminogen Activator Therapy for Stroke Patients Receiving Maintenance Hemodialysis: The Stroke Acute Management with Urgent Risk-Factor Assessment and Improvement (SAMURAI) rt-PA Registry

et al. 2011

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Background: To examine the therapeutic effect of intravenous recombinant tissue plasminogen activator (rt-PA) therapy for stroke patients receiving maintenance hemodialysis (HD). Methods: Of 600 stroke patients receiving intravenous rt-PA using 0.6 mg/kg alteplase who were enrolled in a multicenter observational study in Japan, 4 patients (3 men, 64–77 years old) on maintenance HD were studied. Results: The primary kidney disease requiring HD was glomerulonephritis in 2 patients, diabetic nephropathy in 1, and undetermined in 1. The duration of HD ranged between 1.2 and 28 years. Three patients developed stroke on the day of HD, including 1 during HD and another just after HD. All patients had stroke in the carotid arterial territory. Pretreatment NIH Stroke Scale scores ranged between 4 and 20, and decreased by 2–5 points at 7 days. One patient needed intravenous antihypertensive therapy before rt-PA; he developed an ectopic cortical hematoma and intraventricular hemorrhage after rt-PA. The other 3 did not develop hemorrhagic complications. The modified Rankin Scale score at 3 months was 0 in 1 patient, 2 in 2 patients, and 4 in 1 patient. Conclusions: rt-PA therapy for stroke patients receiving maintenance HD might improve the stroke outcome. Ectopic hematoma was a unique complication in our case series.

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Biphasic effects of hemodialysis on platelet reactivity in patients with end-stage renal disease: A potential contributor to cardiovascular risk

Cited by 62 publications

References 26 publications

The Influence of the Haemodialysis Procedure on Platelets, Coagulation and Fibrinolysis

The Influence of the Haemodialysis Procedure on Platelets, Coagulation and Fibrinolysis

The role of platelets in the prognosis of renal disease

Intravenous Recombinant Tissue Plasminogen Activator Therapy for Stroke Patients Receiving Maintenance Hemodialysis: The Stroke Acute Management with Urgent Risk-Factor Assessment and Improvement (SAMURAI) rt-PA Registry

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