Recombinant human erythropoietin shortens the bleeding time and corrects the abnormal platelet aggregation in hemodialysis patients.
Uremia may be associated with abnormal hemostasis characterized by a prolonged bleeding time and abnormal in-vitro platelet aggregation. The mechanisms underlying these derangements are not fully elucidated. The present study examined the effect of correction of anemia by recombinant human erythropoietin (r-HuEPO) on these abnormalities in eight dialysis patients. Prior to r-HuEPO therapy the patients had low hematocrits (Hct) (20% +/- 0.7), abnormal bleeding times (23 +/- 1.2 minutes), and marked impairment in platelet aggregation induced by adenosine diphosphate (ADP), epinephrine (Epi), thrombin (Th) and collagen. After correction of the anemia to a Hct of 32% +/- 0.9 over 5 +/- 0.9 months, there were a) significant shortening of the bleeding time (from 23 +/- 1.2 to 10.6 +/- 2.4 minutes, p < 0.01), b) an inverse correlation between the Hct and the bleeding time (r = -0.89, p < 0.001) and c) significant improvement, or normalization of platelet aggregation in response to both concentrations of epinephrine [Epi2 (5.4 x 10(-6) M), 45% +/- 10.5 vs 73.5% +/- 7.3, p < 0.01, and Epi1 (5.4 x 10(-5) M), 49% +/- 10.6 vs 64% +/- 6.6, p < 0.05)], both concentrations of ADP [ADPC'(2 x 10(-6) M), 31% +/- 5.9 vs 60% +/- 9.3, p < 0.05, and ADPB (2 x 10-5), 69.5% +/- 7.6 vs 99% +/- 4.8, p < 0.01], and both concentrations of thrombin [ThC (0.22 u/ml) 28.6% +/- 8.9 vs 80.4% +/- 8.3, p < 0.01, and TH50/50 (0.44 u/ml), 57.8% +/- 6.7 vs 83.3% +/- 9.2, p < 0.01)].(ABSTRACT TRUNCATED AT 250 WORDS)
el-Shahawy
M A
MA
Division of Nephrology, University of Southern California School of Medicine, Los Angeles 90033.
Francis
R
R
Akmal
M
M
Massry
S G
SG
D000244:Adenosine Diphosphate / Q000494:pharmacology; D000368:Aged; D000740:Anemia / Q000628:therapy; D001760:Bleeding Time; D003094:Collagen / Q000494:pharmacology; D004837:Epinephrine / Q000494:pharmacology; D004921:Erythropoietin / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006400:Hematocrit; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects*; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use; D006435:Renal Dialysis; D013917:Thrombin / Q000494:pharmacology
D011994:Recombinant Proteins; D004921:Erythropoietin; D000244:Adenosine Diphosphate; D003094:Collagen; D013917:Thrombin; D004837:Epinephrine