Effect of Inhibition of Prostaglandin Synthesis on Platelet Count, Platelet Aggregates and Arterial Oxygen Tension during Hemodialysis

Knudsen, Flemming; Nielsen, Arne Høj; Stoffersen, Erik; Kornerup, H. J.; Dyerberg, Jørn

doi:10.1159/000166461

Cited by 4 publications

(2 citation statements)

References 11 publications

(28 reference statements)

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“…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%

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: Introductionmentioning

confidence: 99%

Polycarbonate versus Cuprophan Dialyzers: Effect on Platelet Function

Knudsen¹,

Nielsen²

1984

Blood Purif

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“…63], Theoretically, the complement system could also be activated via an indirect mechanism dependent on the prior contact activation of factor XII, with subsequent generation of ac tive plasmin and kallikrcin [106], The latter enzymes arc also capable of cleaving comple ment components [107], Such a mechanism, however, has been excluded by demonstrat ing the lack of activation x>f factor XII in a well-designed and carefully controlled study [108], Interestingly, the drop in leukocyte count has not been prevented from occurring by inhibiting prostaglandin synthesis [105], suggesting that these autacoids arc not im portant mediators either. Although some early studies documented a dissociation be tween neutropenia and complement activa tion by the membrane [65,66], more recent reports have provided undisputable evidence linking complement activation with the de velopment of leukopenia [67,68].…”

Section: Role O F Leukocyte Aggregation and Embolizationmentioning

confidence: 99%

Blood Pressure, Ventilation and Lipid Imbalance during Hemodialysis: Effect of Dialysate Composition

Duarte¹

1985

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Regular hemodialysis with either acetate or bicarbonate dialysate can be associated with the development of hypotension and hypoxemia. Hypotension, which is more commonly observed during acetate dialysis, is usually the result of unfavorable alterations in the cardiac output, the peripheral vascular resistance, or both. Complement-mediated leukocyte embolization and hypoventilation represent the major causes of hypoxemia. No consistent long-term effects on lipid balance have been observed with either dialysate.

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

Knudsen

Dyerberg

1985

Scandinavian Journal of Clinical and Laboratory Investigation

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In 14 haemodialysis patients, platelet count, secondary platelet aggregation rate, immunological antithrombin III and antithrombin III activity were lower and plasma beta-thromboglobulin higher than in 14 age- and sex-matched controls. In contrast, primary platelet aggregation, the degree of secondary aggregation and circulating platelet aggregates did not differ. Haemodialysis was associated with signs of platelet damage reflected by increase in plasma beta-thromboglobulin, extraction of platelets in the dialyser and decline in platelet count. Platelets in the dialyser effluent line were less aggregable than platelets in arterial blood. Circulating platelet aggregates and immunological antithrombin III were unchanged during dialysis whereas antithrombin III activity showed a minor rise. In conclusion, uraemics show a decreased rate of secondary platelet aggregation, and haemodialysis confers further platelet injury due to blood/surface interactions during extracorporeal circulation. The defective platelet function and low antithrombin III activity may help to explain the paradoxical occurrence of both haemorrhagic and thrombotic complications in uraemia.

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Effect of Inhibition of Prostaglandin Synthesis on Platelet Count, Platelet Aggregates and Arterial Oxygen Tension during Hemodialysis

Cited by 4 publications

References 11 publications

Polycarbonate versus Cuprophan Dialyzers: Effect on Platelet Function

Polycarbonate versus Cuprophan Dialyzers: Effect on Platelet Function

Blood Pressure, Ventilation and Lipid Imbalance during Hemodialysis: Effect of Dialysate Composition

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

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