Comparison of Haemostatic Activity in Haemodialysis and Peritoneal Dialysis Patients with a Novel Technique, Haemostatometry

Abstract

Bleeding due to impaired primary haemostasis is common in uraemia. However, thromboembolic episodes are also a clinical problem in dialysis patients. Platelet reactivity to shear stress (haemostasis, H1 and H2), exposure to collagen fibre (thrombus growth) and coagulation of flowing blood (clotting time, CT1 and CT2) were measured in non-anticoagulated blood samples taken immediately before and 18-24 h after haemodialysis (n = 26) and from patients maintained on continuous ambulatory peritoneal dialysis (CAPD, n = 30). H1 (p < 0.001), H2 (p < 0.01), percent thrombus growth rate (p < 0.03), CT1 (p < 0.01 and CT2 (p < 0.05) were restored towards normal after haemodialysis. Results obtained in the CAPD patients demonstrated that the mean values for formation of the haemostatic plug lay between the pre- and posthaemodialysis values; however, CT1 (p < 0.01) and CT2 (p < 0.05) were prolonged in CAPD compared with values after haemodialysis. These data, which indicate platelet function from non-anticoagulated blood and coagulation under flow conditions, (1) confirm that there is impaired haemostasis in uraemia; (2) demonstrate an improvement in haemostasis after haemodialysis; (3) show that peritoneal dialysis results in a haemostatic profile which falls between the pre-and posthaemodialysis pattern, and (4) show that neither dialysis modality returns haemostasis to normal.

Abnormal platelet cytoskeletal assembly in hemodialyzed patients results in deficient tyrosine phosphorylation signaling

“…Our als, some of the proteins susceptible to be phosphorypresent observations in this group of patients reinforce lated at tyrosine residues are known to be localized at the findings obtained by other authors in terms of aggrea submembrane level in resting conditions [26]. After gating platelet responses [6,17,37], indicating a recovery thrombin activation and as we have observed in control of the cohesive functions of uremic platelets in patients platelets, they appeared phosphorylated and associated undergoing CAPD. Furthermore, the use of the Baumwith the cytoplasmic cytoskeleton (recovered at the lowgartner perfusion method in our present study has demspeed cytoskeletal fraction).…”

“…The recovery of platelet function was not related to an increase in platelet or erythrocyte mostasis observed by previous authors in patients with counts, nor to an improvement of the uremic milieu. In CAPD treatment [24,25,37].…”

State-of-the-Art Review : Evaluation of the Clot Signature Analyzer as a Hemostasis Test in Healthy Volunteers Exposed to Low Doses of Aspirin

“…Furthermore, the usefulness of the conventional bleeding time (BT) test is still controversial due to the variability of results that is mainly caused by differences in technique used by different individuals (2)(3)(4). The Clot Signature Analyzer (CSA) (Xylum Corp., Scarsdale, NY, U.S.A.) has been developed with the aim of incorporating all aspects of hemostasis into one convenient in vitro procedure (5)(6)(7)(8)(9).…”