Platelets in Advanced Chronic Kidney Disease: Two Sides of the Coin

Lutz, med. Jens; Jurk, PD Dr. rer. nat. Kerstin

doi:10.1055/s-0040-1708841

Cited by 27 publications

(21 citation statements)

References 185 publications

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“…This speculation is based on the observations that IEA is approximately 4.5 cm from the midline at the umbilicus level and has on average 3.3 branches arising from its lateral aspect [9] . In addition, our patient had advanced CKD that is usually associated with platelet dysfunction and subsequent increased risk for bleeding [10] .…”

Section: Discussionmentioning

confidence: 93%

Inferior epigastric artery injury after percutaneous imaging-guided peritoneal dialysis catheter placement

Dryer

Abaza

Almehmi³

2022

Radiology Case Reports

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Inferior epigastric artery (IEA) injury is a rare clinical entity that is usually associated with abdominal wall procedures and injuries though can also be spontaneous, particularly in individuals with coagulopathy. Of all described mechanisms of injury, percutaneous peritoneal dialysis (PD) catheter insertion is a rarely encountered, particularly in instances where insertion is performed under imaging guidance. While this injury is self-limited, it can be associated with hemodynamic instability and acute blood loss anemia, which can be fatal if left untreated. Computed tomographic (CT) angiography is the diagnostic method of choice. Transcatheter arterial embolization is an effective treatment modality with a high success rate. Here, we describe a 41-year-old female who underwent percutaneous PD catheter insertion that, despite intraprocedural imaging guidance, was complicated by large hemoperitoneum and clinical instability. Prompt identification of IEA injury followed by immediate intervention with coil embolization led to a successful outcome for this patient in the setting of a life-threatening uncommon complication of such procedure. The details of the diagnostic evaluation and management are outlined.

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Section: Discussionmentioning

confidence: 93%

Inferior epigastric artery injury after percutaneous imaging-guided peritoneal dialysis catheter placement

Dryer

Abaza

Almehmi³

2022

Radiology Case Reports

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“…CD62P expression and subsequent formation of platelet‐leukocyte aggregates upregulates the pro‐inflammatory function of WBCs [22]. It is worth noting that ESRD patients have higher levels of p‐selectin on the surface of PLT compared with healthy individuals, which can bind to monocytes and NEUT via p‐selectin glycoprotein ligand‐1 (PSGL‐1), and therefore platelets can directly influence leukocyte reactivity and promote leukocyte aggregation to sites of vascular injury, which in turn causes inflammation [23]. In addition, in HD patients, an increase in NEUT‐activated particles can be accompanied by an increasing number of PLT particles, possibly due to the fact that NEUT particles contain PLT‐activating factors, a mediator that may be involved in the inflammatory response [24].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for infection‐related hospitalization in end‐stage renal disease patients during peri‐dialysis period

et al. 2021

Ther Apher Dial

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Infection-related hospitalization during the peri-dialysis period (PDP) in patients with end-stage renal disease (ESRD) has received less attention. Considering the limited data, we explored the risk factors in this population. Retrospective analysis using the data system to examine factors for infection in ESRD during PDP between January 2012 and December 2017. Patients were divided into infected group and non-infected group according to the history of infection. Binary Logistic Regression Model was used to search for risk factors. A total of 478 patients were hospitalized during their PDP. One hundred and ninety patients developed infection (39.75%). Thirty-six patients (18.95%) had two or more infection events, all due to recurrent respiratory infections. The respiratory system was the main site of infection (63.68%), followed by the urinary system and digestive system. Compared with the non-infected group, the infected group had more patients with hypoproteinemia and coronary heart disease. The following factors: C-reactive protein >15 mg/L, procalcitonin >1 ng/L, neutrophil percentage >75%, age >52.5 years, platelet >300 Â 10 9 /L, neutrophil to lymphocyte ratio, and concomitant coronary heart disease were associated with the occurrence of infection in ESRD patients during PDP. Patients with ESRD have a high incidence of infection during the PDP, with respiratory infection most commonly seen. This research identified several factors associated with risk for infection, which should guide the design of infection prevention strategies.

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“…Furthermore, platelets release more α -granules on stimulation, leading to increased incorporation and expression of P-selectin on the platelet surface, which, in turn, binds to PGSL-1, which is expressed on various leukocyte subsets, including neutrophils 103 . Thus, uremic platelet dysfunction not only promotes bleeding complications 104 but also immunothrombosis in CKD 105 , 106 …”

Section: Immunophenotype Of Patients With Kidney Diseasementioning

confidence: 99%

Secondary Immunodeficiency Related to Kidney Disease (SIDKD)—Definition, Unmet Need, and Mechanisms

Steiger

Rossaint

Zarbock

et al. 2022

JASN

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Kidney disease is a known risk factor for poor outcome of COVID-19 and many other serious infections. Vice versa, infection ranks second as cause of death in patients with kidney disease. However, little is known about the underlying secondary immunodeficiency related to kidney disease (SIDKD). In contrast to cardiovascular disease related to kidney disease, which has triggered countless epidemiological, clinical, and experimental research activities or interventional trials, investments in tracing, understanding, and therapeutically targeting SIDKD have been sparse. As a call for more awareness of SIDKD as an immanent unmet medical need that requires rigorous research activities at all levels, too, we review the epidemiology of SIDKD and the numerous aspects of the abnormal immunophenotype of patients with kidney disease. We propose a definition of SIDKD and discuss the pathogenic mechanisms of SIDKD known so far, including more recent insights into the unexpected immunoregulatory roles of elevated levels of FGF23 and hyperuricemia as well as shifts in the secretome of the intestinal microbiota in kidney disease. As an ultimate goal, we should aim to develop therapeutics that can reduce mortality due to infections in patients with kidney disease by normalizing host defense to pathogens and immune responses to vaccines.

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Platelets in Advanced Chronic Kidney Disease: Two Sides of the Coin

Cited by 27 publications

References 185 publications

Inferior epigastric artery injury after percutaneous imaging-guided peritoneal dialysis catheter placement

Inferior epigastric artery injury after percutaneous imaging-guided peritoneal dialysis catheter placement

Risk factors for infection‐related hospitalization in end‐stage renal disease patients during peri‐dialysis period

Secondary Immunodeficiency Related to Kidney Disease (SIDKD)—Definition, Unmet Need, and Mechanisms

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