Prothrombotic Changes in Platelet, Endothelial and Coagulation Function following Hemodialysis

Purpose Patients on hemodialysis (HD) have an increased risk of thrombotic events, including myocardial infarction and vascular access thrombosis. The study hypothesis is that a single session of dialysis leads to platelet, endothelial & coagulation activation. Our aim is to determine the effect...

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Bibliographic Details
Published in:International journal of artificial organs 2011-03, Vol.34 (3), p.280-287
Main Authors: Milburn, James A., Cassar, Kevin, Ford, Isobel, Fluck, Nicholas, Brittenden, Julie
Format: Article
Language:English
Subjects:
Acid phosphatase (tartrate-resistant)
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Blood Coagulation - physiology
Blood Platelets - physiology
Cardiology. Vascular system
Emergency and intensive care: renal failure. Dialysis management
Endothelial Cells - physiology
Female
Flow Cytometry
Hemodynamics
Humans
Intensive care medicine
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - therapy
Male
Medical sciences
Middle Aged
Platelet Activation - physiology
Renal Dialysis
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Summary:Purpose Patients on hemodialysis (HD) have an increased risk of thrombotic events, including myocardial infarction and vascular access thrombosis. The study hypothesis is that a single session of dialysis leads to platelet, endothelial & coagulation activation. Our aim is to determine the effect of a single HD session on prothrombotic vascular biomarkers before and after a single session of hemodialysis. Methods Blood samples were taken from the vascular access of 55 patients immediately before and after a hemodialysis session. Platelet function was assessed by (1) flow cytometric measurement of P-selectin expression and fibrinogen binding ± ADP stimulation, (2) Ultegra rapid platelet function assay (RPFA) using the agonists thrombin receptor activating peptide (TRAP) and arachidonic acid (AA), (3) soluble P-selectin, and (4) soluble CD40L. Coagulation (thrombin-antithrombin III [TAT] and D-dimer), endothelial von Willebrand factor (vWF) and high sensitivity C-Reactive protein (hsCRP) were assessed by ELISA. Results Unfractionated heparin was given to all patients during dialysis and 30 patients (55%) were on antiplatelet agents. Post-hemodialysis there were significant increases in unstimulated platelet P-selectin (p=.037), stimulated P-selectin (p
ISSN:0391-3988
1724-6040
DOI:10.5301/IJAO.2011.6469