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Original Paper

The Role of the Extracorporeal Circuit in the Trapping and Degranulation of Platelets

Gritters-van den Oever M.a, c · Schoorl M.b · Schoorl M.b · Bartels P.C.M.b · Grooteman M.P.C.c · Nubé M.J.a, c

Author affiliations

aDepartment of Nephrology and bDepartment of Clinical Chemistry, Haematology and Immunology, Medical Centre Alkmaar, Alkmaar, and cDepartment of Nephrology, VU University Medical Centre, Amsterdam, The Netherlands

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Blood Purif 2009;28:253–259

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 29, 2008
Accepted: March 18, 2009
Published online: August 14, 2009
Issue release date: October 2009

Number of Print Pages: 7
Number of Figures: 5
Number of Tables: 1

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Background: Although platelet (PLT) activation and degranulation are well-known phenomena during hemodialysis (HD), controversies still exist about their nature and origin. Methods: PLT characteristics [PLT numbers, mean PLT volume (MPV), PLT distribution width (PDW), PLT large cell ratio (p-LCR), immature PLT fraction] and activation status [CD62p expression, platelet factor 4 (PF4) and β-thromboglobulin (BTG) plasma levels] were estimated in 19 patients before and during HD. Blood was sampled from both the afferent and efferent lines. Additionally, the influence of low-molecular-weight heparin (LMWH) on PF4 and BTG concentrations was analyzed. Results: CD62p expression increased in the extracorporeal circuit (ECC) in the first 30 min. Simultaneously, PLT numbers dropped markedly within the ECC. MPV, PDW and p-LCR decreased over time. Like CD62p expression, BTG reached peak values at t30, was exclusively released within the ECC and was not influenced by the application of LMWH. In contrast, PF4 was significantly released outside the ECC in response to LMWH. Conclusions: PLTs are predominantly activated within the ECC and not on a remote distance. PLTs stick to the ECC, particularly after first passage. BTG is an appropriate marker for HD-induced PLT degranulation, whereas PF4 originates from both activated PLTs and LMWH-induced detachment from the endothelium. PLTs are not exhausted due to the repetitive stimulation of clinical HD. Hence, dialysis modalities with longer duration or greater frequency may be associated with a less beneficial PLT activation profile, which may counteract their clinical benefits.

© 2009 S. Karger AG, Basel


References

  1. Grooteman MPC, Nubé MJ: Haemodialysis-related bio-incompatibility: fundamental aspects and clinical relevance. Neth J Med 1998;5:169–178.
    External Resources
  2. Gritters M, Borgdorff P, Grooteman MPC, Schoorl M, Schoorl M, Bartels PCM, Tangelder GJ, Nubé MJ: Platelet activation in clinical haemodialysis: LMWH as a major contributor to bio-incompatibility? Nephrol Dial Transplant 2008;9:2911–2917.
    External Resources
  3. Cianciolo G, Stefoni S, Donati G, De Pascalis A, Iannelli S, Manna C, Colì L, et al: Intra- and post-dialytic platelet activation and PDGF-AB release: cellulose diacetate versus polysulfone membranes. Nephrol Dial Transplant 2001;6:1222–1229.
    External Resources
  4. De Bruijne-Admiraal LG, Modderman PW, von dem Borne AE, Sonnenberg A: P-selectin mediates Ca(2+)-dependent adhesion of activated platelets to many different types of leukocytes: detection by flow cytometry. Blood 1992;1:134–142.
  5. Sirolli V, Strizzi L, Di Stante S, Robuffo I, Procopio A, Bonomini M: Platelet activation and platelet-erythrocyte aggregates in end-stage renal disease patients on hemodialysis. Thromb Haemost 2001;3:834–839.
  6. Bonomini M, Stuard S, Carreno MP, Settefrati N, Santarelli P, Haeffner-Cavaillon N, Albertazzi A: Neutrophil reactive oxygen species production during hemodialysis: role of activated platelet adhesion to neutrophils through P-selectin. Nephron 1997;4:402–411.
    External Resources
  7. Nassar T, Sachais BS, Akkawi S, Kowalska MA, Bdeir K, Leitersdorf E, Hiss E, et al: Platelet factor 4 enhances the binding of oxidized low-density lipoprotein to vascular wall cells. J Biol Chem 2003;278:6187–6193.
  8. Salvati F, Liani M: Role of platelet surface receptor abnormalities in the bleeding and thrombotic diathesis of uremic patients on hemodialysis and peritoneal dialysis. Int J Artif Organs 2001;3:131–135.
  9. Chuang YC, Chen JB, Yang LC, Kuo CY: Significance of platelet activation in vascular access survival of haemodialysis patients. Nephrol Dial Transplant 2003;5:947–954.
    External Resources
  10. Aggarwal A, Kabbani SS, Rimmer JM, Gennari FJ, Taatjes DJ, Sobel BE, Schneider DJ: Biphasic effects of hemodialysis on platelet reactivity in patients with end-stage renal disease: a potential contributor to cardiovascular risk. Am J Kidney Dis 2002;2:315–322.
    External Resources
  11. Ashman N, Macey MG, Fan SL, Azam U, Yaqoob MM: Increased platelet-monocyte aggregates and cardiovascular disease in end-stage renal failure patients. Nephrol Dial Transplant 2003;10:2088–2096.
    External Resources
  12. Landray MJ, Wheeler DC, Lip GY, Newman DJ, Blann AD, McGlynn FJ, Ball S, Townend JN, Baigent C: Inflammation, endothelial dysfunction, and platelet activation in patients with chronic kidney disease: the chronic renal impairment in Birmingham (CRIB) study. Am J Kidney Dis 2004;2:244–253.
    External Resources
  13. Grooteman MPC, Bos JC, van Houte AJ, van Limbeek J, Schoorl M, Nubé MJ: Mechanisms of intra-dialyser granulocyte activation: a sequential dialyser elution study. Nephrol Dial Transplant 1997;3:492–499.
    External Resources
  14. Schoorl M, Schoorl M, Bartels PCM: Changes in platelet volume, morphology and RNA content in subjects treated with haemodialysis. Scand J Clin Lab Invest 2008;4:335–342.
    External Resources
  15. Aggarwal A, Kabbani SS, Rimmer JM, Gennari FJ, Taatjes DJ, Sobel BE, Schneider DJ: Biphasic effects of hemodialysis on platelet reactivity in patients with end-stage renal disease: a potential contributor to cardiovascular risk. Am J Kidney Dis 2002;2:315–322.
    External Resources
  16. Nubé MJ, Grooteman MPC: Overview of dialyzer elution studies: impact on current views on bioincompatibility and future perspectives. Neth J Med 1998;5:160–168.
    External Resources
  17. Falkenhagen D, Mitzner S, Stange J, Klinkmann H: Biocompatibility: methodology and evaluation. Contrib Nephrol 1993;103:34–54.
  18. Vanholder R, De Smet R, Glorieux G, Argilés A, Baurmeister U, Brunet P, Clark W, et al: Review on uremic toxins: classification, concentration, and interindividual variability. Kidney Int 2003;5:1934–1943.
    External Resources
  19. Ross R: Atherosclerosis – an inflammatory disease. N Engl J Med 1999;2:115–126.
    External Resources
  20. van der Weerd NC, Penne EL, van den Dorpel MA, Grooteman MPC, Nubé MJ, Bots ML, ter Wee PM, Blankestijn PJ: Haemodiafiltration: promise for the future? Nephrol Dial Transplant 2008;2:438–443.
  21. Kundhal K, Pierratos A, Chan CT: Newer paradigms in renal replacement therapy: will they alter cardiovascular outcomes? Cardiol Clin 2005;3:385–391.
    External Resources

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 29, 2008
Accepted: March 18, 2009
Published online: August 14, 2009
Issue release date: October 2009

Number of Print Pages: 7
Number of Figures: 5
Number of Tables: 1

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU


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