Erythropoietin and fibrinolysis effects on platelet activity

Effects of Epoetin Alfa on Hemostasis in Chronic Renal Failure

“…Four studies (14-78 patients) reported an increase in MPV [6,19,20,25], four studies (9-19 patients) reported no change [10,26,29,30], and one study reported a decrease [14]. The latter study reported 27 and 21% decreases in MPV 6 and 12 weeks, respectively, after the initiation of Epoetin alfa therapy in 9 pediatric hemodialysis patients [14].…”

“…Malyszko et al [22] studied 22 hemodialysis patients and reported a transient 15% increase in the plasma ß-thromboglobulin concentration 2 weeks following the subcutaneous administration of Epoetin alfa; the increase resolved by week 4. In contrast, Takayama [27] found no changes in the plasma ß-thromboglobulin concentration after 4, 8, and 12 weeks of Epoetin alfa therapy; nor did Stenver et al [26] after 6 months of Epoetin alfa administration.…”

“…The increase in platelet count was not affected by the rate at which the hemoglobin concentration or hematocrit increased or by the hematocrit achieved. The rates at which the hemoglobin concentration increased ranged from 0.17 to 0.44 g/ dl/week in the studies that reported an increase in the platelet count [14,21] and did not differ from those in which platelet count did not change significantly (range 0.17-0.36 g/dl/week) [26,32]. Similarly, hematocrits of 36 and 37% were achieved in studies in which the platelet counts increased [14] or remained static [23,25], respectively.…”

“…No changes in the platelet factor 4 concentration were noted in these three studies, whereas the ß-thromboglobulin concentration was increased in one study [22] and unchanged in the other two studies [26,27]. Malyszko et al [22] studied 22 hemodialysis patients and reported a transient 15% increase in the plasma ß-thromboglobulin concentration 2 weeks following the subcutaneous administration of Epoetin alfa; the increase resolved by week 4.…”

“…Several groups have examined platelet activity by measuring intravascular markers of platelet activation such as platelet factor 4 and ß-thromboglobulin [22,26,27]. No changes in the platelet factor 4 concentration were noted in these three studies, whereas the ß-thromboglobulin concentration was increased in one study [22] and unchanged in the other two studies [26,27].…”