Skin Bleeding Time for the Evaluation of Uremic Platelet Dysfunction and Effect of Dialysis

Soyoral, Yasemin Usul; Demir, Cengiz; Beğenik, Hüseyin; Esen, Ramazan; Küçükoğlu, Mehmet Emin; Aldemir, Mehmet Naci; Demirkıran, Davut; Erkoç, Reha

doi:10.1177/1076029611427438

Cited by 16 publications

(12 citation statements)

References 18 publications

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“…Soyoral et al reported that skin bleeding-time after the first HD was shorter compared to the pre-dialysis value, because HD improves uremia and platelet function 21 . Winkelmayer et al reported that CKD was associated with the risk for postoperative bleeding in patients undergoing coronary artery bypass grafting surgery, not only at more advanced stages, but probably also at relatively mild levels of renal impairment 22 .…”

Section: Discussionmentioning

confidence: 99%

Renal dysfunction is an independent risk factor for bleeding after gastric ESD

Yoshioka

Nishida

Tsujii

et al. 2014

EIO

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Background and study aims: The number of patients with chronic kidney disease (CKD) is increasing worldwide and gastric cancer sometimes occurs with CKD. However, the safety and feasibility of endoscopic submucosal dissection (ESD) for patients with CKD are not clear. The aim of this study is to clarify the feasibility and safety of gastric ESD for patients with CKD. Patients and methods: This was a multicenter retrospective cohort study. In total, 144 patients with CKD who underwent gastric ESD between May 2003 and October 2012 were enrolled. The patients were divided into three groups: stage 3 (estimated glomerular filtration rate [eGFR]: 30 – 59 mL/min), stage 4 (eGFR: 15 – 29 mL/min), and stage 5 (eGFR: < 15 mL/min) according to the Kidney Disease Improving Global Outcomes Guidelines. The en bloc and curative resection rates and complications were assessed as short-term outcomes. Overall survival was analyzed using Kaplan – Meier methods. Results: In total, 92 patients were in stage 3 CKD; 23 in stage 4; and 29 in stage 5, including 19 patients in hemodialysis. The en bloc resection rate was 95.8 %. Post-ESD bleeding was observed in four patients with stage 5 CKD (13.8 %), three with stage 4 (13.0 %), and one with stage 3 (1.1 %). All bleeding could be controlled by endoscopic hemostasis, but five patients required blood transfusion. Perforation occurred in two patients (6.9 %) with stage 5 CKD, none (0 %) with stage 4, and two (4.3 %) with stage 3. Multivariate Poisson regression analysis revealed CKD stage 4 was a critical factor related to bleeding, whereas diabetes mellitus and CKD stage 5, which largely consist of patients receiving hemodialysis, were not. The median observation period of patients who achieved curative resection was 25.9 months (range 0.8—112.7 months) and the 3-year overall survival rate was 92.5 %. Conclusions: Estimated GFR is a significant independent predictive factor of post-ESD bleeding in patients with CKD.

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Section: Discussionmentioning

confidence: 99%

Renal dysfunction is an independent risk factor for bleeding after gastric ESD

Yoshioka

Nishida

Tsujii

et al. 2014

EIO

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“…Altman et al [16] reported the correlation between results of template BT and degree of platelet inhibition as well as bleeding episodes in patients who were under aspirin and clopidogrel treatment. About evaluation of bleeding in patients with renal failure, previous data found that BT was a useful test to evaluate bleeding risk in uremic patients [17,18]. Another preanalytical issue of BT is the setting of rejection criteria for patients with anemia and/or thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

Current practices of bleeding time in a developing country: an alert for noncompliance with the standard procedures

Tantanate

Tientadakul

2013

Int J Lab Hematology

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“…Classically, the in vivo bleeding time according to the template or Ivy bleeding time test has been shown to reflect global hemostatic defects in uremia in smaller studies. 103 Under standardized conditions with a sphygmomanometer at the forearm inflated to 40 mm Hg, to control the venous pressure, two standardized incisions are made at the volar Fig. 3 Effect of hemodialysis on platelets.…”

Section: Skin Bleeding Timementioning

confidence: 99%

“…An analysis of patients after the initiation of dialysis revealed that the skin bleeding time was significantly reduced with regular dialysis. 103 However, due to questionable accuracy and reproducibility, this test is obsolete.…”

Section: Skin Bleeding Timementioning

confidence: 99%

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

Lutz¹,

Jurk

2020

Semin Thromb Hemost

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Rates of thrombosis and bleeding episodes are both increased in patients with advanced chronic kidney disease (CKD). The pathogenic mechanisms of thrombosis in these patients include platelet activation, increased formation of platelet-leukocyte conjugates, and platelet-derived microparticles, as well as effects of uremic toxins on platelets. On the other side of the coin, platelet hyporeactivity mediated by uremic toxins and anemia contributes to the increased bleeding risk in advanced CKD. Platelets also contribute to the inflammatory environment, thus increasing the risk of cardiovascular diseases in these patients. This review provides insights into the altered platelet function in advanced stages of CKD and their relationship with risks of thrombosis and bleeding. Particularly, the effect of dialysis on platelets will be discussed. Furthermore, therapeutic options with respect to thrombotic disorders as well as bleeding in patients with CKD are reviewed.

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Skin Bleeding Time for the Evaluation of Uremic Platelet Dysfunction and Effect of Dialysis

Cited by 16 publications

References 18 publications

Renal dysfunction is an independent risk factor for bleeding after gastric ESD

Renal dysfunction is an independent risk factor for bleeding after gastric ESD

Current practices of bleeding time in a developing country: an alert for noncompliance with the standard procedures

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

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