Platelet hyperreactivity in hemodialysis patients with frequently occluded vascular access.

Abstract:

:It is known that thrombosis is a leading cause of vascular access failure and that the formation of thrombus requires platelets. The activation of platelets induces the increase in intracellular Ca 2(+) levels ([Ca(2+)](i)) leading to aggregation and thrombosis. We compared the platelet [Ca(2+)](i) before and after stimulation between the patients with and without easily occluded vascular access. Our study included two groups of hemodialysis patients. Group 1 consisted of 21 patients who had received chronic hemodialysis therapy for more than 6 months. They had had more than three events (including three) of vascular access failures during the past year. Group 2 consisted of 21 hemodialysis patients with age, sex, and diabetes mellitus matched who had never suffered from any event of vascular access failure. We measured the basal and stimulated platelet [Ca(2+)](i) after stimulation with 1 U/ml thrombin, 1 micro M arachidonic acid, 1 micro M platelet activation factor (PAF), and 10 micro M adenosine diphosphate (ADP), respectively. Our results showed that in Ca 2(+)-containing media, there was no significant differences in the basal [Ca(2+)](i), but the maximal increases of [Ca(2+)](i) of platelets were higher (p <0.05) in group 1 than in group 2 after stimulating with PAF and ADP, but not with thrombin and arachidonic acid. We concluded that the causes for the susceptibility of some hemodialysis patients to vascular access occlusion were multifactorial. In addition to previously reported plasma factors, there was a sub-group of patients who showed greater elevations of agonists stimulated platelet intracellular calcium levels.

journal_name

Thromb Haemost

authors

Chou KJ,Jan CR,Lee PT,Chen CL,Chung HM,Hwang YY,Chou JD,Fang HC

doi

10.1160/TH04-01-0048

keywords:

subject

Has Abstract

pub_date

2004-09-01 00:00:00

pages

621-6

issue

3

eissn

0340-6245

issn

2567-689X

pii

04090621

journal_volume

92

pub_type

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