title: Mild-to-moderate renal impairment is associated with platelet activation: a cross-sectional study.
abstract: The high incidence of cardiovascular disease in patients with moderate renal impairment is not fully explained by traditional atherothrombotic risk factors. Independently from these factors, blood platelet activation may increase the cardiovascular disease risk of patients with mild-to-moderate renal impairment. Blood platelet activation has not been studied in nondiabetic patients with mild-to-moderate renal impairment. Therefore, we measured the extent of platelet activation by means of fluorescence cytometry in 93 nondiabetic patients with MDRD-estimated creatinine clearance ranging from 13 - 63 ml/min/1.73 m2. As platelet activation parameters we used the expression of CD62P (P-selectin), CD 63 (glycoprotein 53), PAC-1 (activated fibrinogen receptor), CD42b (von Willebrand factor receptor) and CD41 (fibrinogen receptor) on the platelet surface membrane. The expression of CD62p, CD63 and PAC-1 was statistically significantly inversely related to the estimated glomerular filtration rate in these patients (standardized b -0.28, -0.32 and -0.39, respectively). We conclude that nondiabetic mild-to-moderate renal impairment is associated with blood platelet activation. Whether this contributes to the increased cardiovascular risk in these patients needs further study.
authors.affiliation: Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands. a.thijs@vumc.nl
authors.forename: A
authors.initials: A
authors.lastname: Thijs
authors.forename: P W B
authors.initials: PW
authors.lastname: Nanayakkara
authors.forename: P M
authors.initials: PM
authors.lastname: Ter Wee
authors.forename: P C
authors.initials: PC
authors.lastname: Huijgens
authors.forename: C
authors.initials: C
authors.lastname: van Guldener
authors.forename: C D A
authors.initials: CD
authors.lastname: Stehouwer
mesh_terms: D000704:Analysis of Variance; D015703:Antigens, CD / Q000097:blood; D000975:Antioxidants / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D010919:Placebos; D015539:Platelet Activation / Q000502:physiology*; D040201:Platelet Membrane Glycoprotein IIb / Q000097:blood; D010980:Platelet Membrane Glycoproteins / Q000378:metabolism; D039341:Receptors, Fibrinogen / Q000097:blood; D012307:Risk Factors; D060149:Tetraspanin 30
chemical_list: D015703:Antigens, CD; D000975:Antioxidants; D015415:Biomarkers; C554586:CD63 protein, human; D019007:P-Selectin; D010919:Placebos; D040201:Platelet Membrane Glycoprotein IIb; D010980:Platelet Membrane Glycoproteins; D039341:Receptors, Fibrinogen; D060149:Tetraspanin 30; C028254:von Willebrand factor receptor; D003404:Creatinine