Author/Editor     Šabovič, Mišo; Salobir, Barbara; Preložnik-Zupan, Irena; Bratina, Petra; Bojec, Vida; Buturović-Ponikvar, Jadranka
Title     The influence of the haemodialysis procedure on platelets, coagulation and fibrinolysis
Type     članek
Source     Pathophysiol Haemost Thromb
Vol. and No.     Letnik 34, št. 6
Publication year     2005
Volume     str. 274-8
Language     eng
Abstract     In end-stage renal disease, in particularly when treated with haemodialysis, the function of platelets, coagulation and fibrinolytic systems can be disturbed, thus contributing to either thrombotic or bleeding complications. It is important to know whether the currently used haemodialysis procedure itself (by biocompatible membranes and better anticoagulation with nandroparin) affects platelets, coagulation or fibrinolysis. In 15 patients who had been treated with chronic haemodialysis, we measured and compared platelet aggregation (induced by adenosine diphosphate, collagen and epinephrine), the markers of coagulation and fibrinolysis activation (thrombin-antithrombin complexes, thrombin fragments F1+2, D-dimer), and fibrinolytic parameters, i.e. fibrinogen, plasminogen, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 1 antigen and activity, before and immediately after the regular haemodialysis sessions. We did not find differences between pre- and post-haemodialysis platelet aggregation induced with all agents. Markers of coagulation and fibrinolysis activation remained unchanged during the process of haemodialysis. However, in post-haemodialysis samples, t-PA activity was significantly increased. Other fibrinolytic parameters remained unchanged. In conclusion, our results showed that the current technique of haemodialysis procedure does not affect platelet aggregation or activate coagulation, and therefore, does not contribute to a thrombotic tendency. However, it does directly affect fibrinolysis through activation of t-PA, which might be clinically relevant since this could increase the bleeding tendency in some haemodialysis patients.
Descriptors     KIDNEY FAILURE, CHRONIC
HEMODIALYSIS
BLOOD COAGULATION
BLOOD COAGULATION DISORDERS
BLOOD PLATELETS
AGED
MIDDLE AGE
FIBRINOLYSIS
HEMORRHAGE
PLATELET AGGREGATION
THROMBOSIS