title: Platelet depletion, platelet activation and coagulation during treatment with hemodialysis.
abstract: Bioincompatibility is the total of side effects during hemodialysis (HD) including, amongst others, changes in platelet (PLT) level. Deviations in PLT count, immature PLT count, PLT morphology, CD62p expression, Platelet Factor 4 (PF4), β-Thromboglobulin (β-TG), serotonin, Thrombin-Antithrombin III (TAT) and Prothrombin Fragment 1+2 (F1+2) are monitored before and during treatment with HD in order to elucidate the interaction between modifications in PLT morphology, PLT activation and markers concerning activation of coagulation. Different patterns with time indicate that there is no correlation between an increased amount of depleted PLTs and increased amounts of PLT activation markers such as CD62p, PF4, β-TG and serotonin. A statistically significant correlation between increased PLT activation markers and markers for increased activation of coagulation such as TAT and F1+2 has not been established. Only a weak correlation is demonstrated between the increase of markers for activation of coagulation and the decrease in PLT counts, immature PLT counts and depleted PLTs during HD treatment. The change in the extracorporeal circuit during HD is probably a more critical factor in the mechanism leading to activation of the coagulation pathway than the modifications in PLT morphology.
authors.affiliation: Department of Clinical Chemistry, Hematology & Immunology, Medical Center Alkmaar, The Netherlands. m.i.schoorl@mca.nl
authors.forename: Marianne
authors.initials: M
authors.lastname: Schoorl
authors.forename: Margreet
authors.initials: M
authors.lastname: Schoorl
authors.forename: Menso J
authors.initials: MJ
authors.lastname: Nubé
authors.forename: Piet C M
authors.initials: PC
authors.lastname: Bartels
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D001792:Blood Platelets / Q000473:pathology*; D048430:Cell Shape; D006801:Humans; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010447:Peptide Hydrolases / Q000097:blood; D015539:Platelet Activation; D010976:Platelet Count; D010978:Platelet Factor 4 / Q000097:blood; D011516:Prothrombin; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000628:therapy*; D012701:Serotonin / Q000097:blood; D013927:Thrombosis / Q000209:etiology; D001620:beta-Thromboglobulin / Q000378:metabolism
chemical_list: D015415:Biomarkers; D019007:P-Selectin; D010446:Peptide Fragments; C046193:antithrombin III-protease complex; D001620:beta-Thromboglobulin; C045879:prothrombin fragment 1.2; D012701:Serotonin; D010978:Platelet Factor 4; D000990:Antithrombin III; D011516:Prothrombin; D010447:Peptide Hydrolases