Platelet reactivity in patients with chronic kidney disease and hemodialysis
End stage renal disease requiring hemodialysis (HD) is frequent and coronary artery disease (CAD) is a common comorbidity. It is associated with bleeding and ischemic events. Platelet reactivity is a well-known determinant of both. However, the impact of HD due to end stage chronic kidney disease (CKD) on platelet reactivity is unknown. Therefore in this study, we evaluated platelet reactivity during hemodialysis in patients with CKD and coronary artery disease. 22 patients with CKD, HD and CAD were included in this study. Light transmission aggregometry (LTA) and flow cytometry were used for evaluating platelet function immediately before and 2 h after initiation of HD. Arachidonic acid-induced maximum of aggregation (MoApre HD: 27.36% ± 25.23% vs. MoAduring HD: 28.05% ± 23.50%, p value = 0.822), adenosine diphosphate (ADP)-induced platelet aggregation (MoApre HD: 65.36% ± 12.88% vs. MoAduring HD: 61.55% ± 17.17%, p-value = 0.09) and collagen-induced platelet aggregation (MoApre HD: 62.18% ± 18.14% vs. MoAduring HD: 64.82% ± 18.31%, p-value = 0.375) were not affected by HD. P-selectin expression was significantly lower after 2 h of HD (pre HD: 31.56% ± 18.99%, during HD: 23.97% ± 15.28%, p = 0.026). In this pilot study, HD did not enhance platelet aggregation. Baseline platelet reactivity was decreased during HD.
KeywordsAggregation Chronic kidney disease Coronary artery disease Hemodialysis Platelets
Coronary artery disease
Chronic kidney disease
Fluorescence activated cell sorting
Light transmission aggregometry
Maximum of aggregation
Platelet rich plasma
PM and LD designed the study, analyzed and interpreted data and wrote the manuscript. CH, TH collected data and revised the manuscript. BL, TP, TZ, MK, JS and AP supervised the study and revised the manuscript.
This work was supported by the Forschungskommission of the Medical Faculty of the Heinrich Heine University (No. 16-2014 to A.P.; No. 46-2016 to L.D.) and by the German Research Foundation (PO 2247/1-1 to A.P.)
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflicts to disclose.
The study conformed to the Declaration of Helsinki and was approved by the University of Düsseldorf Ethics Committee.
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