Effect of hemodialysis on platelet function in end-stage renal disease Egyptian patients using in vitro closure time test (PFA-100 analyzer)

• Published in: Platelets (Edinburgh) Vol. 26; no. 5; pp. 443 - 447
• Main Authors: Mekawy, Mohamed A., Habashy, Deena M. M., Abd El-Mohsen, Waleed A. M.
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 04.07.2015; Taylor & Francis
• Subjects: Adult; Blood Platelets - metabolism; Case-Control Studies; Erythrocyte Indices; Female; Hemodialysis; Humans; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - therapy; Male; Middle Aged; PFA-100; Platelet Count; platelet function; Platelet Function Tests - instrumentation; Platelet Function Tests - methods; Renal Dialysis - adverse effects; Young Adult; platelet function; PFA-100; Hemodialysis
• ISSN: 0953-7104; 1369-1635; 1369-1635
• DOI: 10.3109/09537104.2014.931569

Abstract In patients with end-stage renal disease (ESRD), hemorrhagic complications are commonly encountered due to abnormalities in primary hemostasis, in particular, platelet (PLT) dysfunction and impaired PLT-vessel wall interaction. The pathogenesis of altered PLT function is considered multifactorial. Dialysis procedures had a favorable impact on bleeding complications in uremic patients. We aimed to evaluate the effect of hemodialysis on PLT function in patients with ESRD on a regular hemodialysis program. This study was carried on 40 ESRD Egyptian patients undergoing regular hemodialysis. Twenty healthy subjects were studied as a control group. Samples were assayed for PLT function by PLT function analyzer-100 (PFA-100) before and after the hemodialysis session. Prolonged closure time (CT) was found in 90% of patients before hemodialysis session and returned to normal ranges after hemodialysis session in 22% of those patients. The CT was longer among patients before and after hemodialysis session compared to controls (p < 0.01 and p = 0.02, respectively), while it was shorter among patients after hemodialysis session compared to before hemodialysis session (p = 0.004). Hemoglobin (Hb) level and hematocrit (Hct) values were higher in control group compared to patient group before hemodialysis session (p < 0.01 and p = 0.001, respectively), patients after hemodialysis session (p < 0.01 and p = 0.02, respectively) and also in patients after hemodialysis compared to before hemodialysis session (p = 0.001 and p < 0.01, respectively). The percentage change in PLT count was positively correlated with that of Hb (p = 0.01). We concluded that PLT dysfunction is encountered in ESRD Egyptian patients, and hemodialysis has the ability to correct some part of these hemostatic disturbances.