Hemodialysis-associated platelet activation and thrombocytopenia.
The interactions between platelets and dialysis membranes were studied prospectively in 10 patients undergoing long-term stable dialysis. Transient but significant thrombocytopenia and platelet activation were found during dialysis with the commonly used cuprophane membrane. Platelet counts decreased from 231 +/- 21 X 10(3)/mm3 before dialysis to 127 +/- 28 X 10(3)/mm3 at 90 minutes following initiation of dialysis (p less than or equal to 0.007). Thromboxane B2, an index of platelet activation, also increased from a baseline level of 1.06 +/- 0.2 pg/10(6) platelets to 7.3 +/- 3.0 pg/10(6) platelets at 90 minutes (p less than or equal to 0.04). Cuprophane membranes were also shown to induce complement activation with C3a desArg, the stable derivative of C3 activation, showing a threefold increase from baseline 15 minutes after initiation of dialysis. In contrast, during dialysis with a non-complement-activating dialyzer membrane, polymethylmethacrylate, thrombocytopenia and platelet activation were not observed. These data suggest that platelet activation and thrombocytopenia during hemodialysis are associated with complement activation during hemodialysis in a manner similar to dialysis-associated neutropenia.
D015121:6-Ketoprostaglandin F1 alpha / Q000097:blood; D001792:Blood Platelets / Q000503:physiopathology*; D002482:Cellulose / Q000031:analogs & derivatives; D003167:Complement Activation; D011464:Epoprostenol / Q000378:metabolism; D006801:Humans; D008567:Membranes, Artificial; D008768:Methylmethacrylates; D010976:Platelet Count; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D013921:Thrombocytopenia / Q000209:etiology*; D013929:Thromboxane B2 / Q000097:blood; D013997:Time Factors
D008567:Membranes, Artificial; D008768:Methylmethacrylates; D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha; D002482:Cellulose; C009865:cuprammonium cellulose; D011464:Epoprostenol