title: Platelet Hyperaggregability is Highly Prevalent in Patients With Chronic Kidney Disease: An Underestimated Risk Indicator of Thromboembolic Events.
abstract: BACKGROUND
  Platelet hyperaggregation is known to be associated with arterial and venous thromboembolic events. The prevalence of platelet hyperaggregation in patients with chronic kidney disease (CKD) has not been described to date.
  
  
  METHODS
  Platelet hyperaggregation in patients with renal disease was defined by comparison of platelet aggregation patterns to non-CKD patients without thromboembolic disorders and healthy controls.
  
  
  RESULTS
  Among the 30 hemodialysis patients and 34 renal transplant recipients, 20 (67%) and 28 (82%) showed significantly decreased median Δ-epinephrine aggregation and increased 0.5 mol/L epinephrine response (65% and 54%) compared to healthy controls and non-CKD patients. In concordance to the laboratory finding of platelet hyperaggregability, renal transplant recipients showed a high rate of thromboembolic events (normal platelet aggregation: 0 events and platelet hyperaggregation: 30 events in 13 of 28 patients).
  
  
  CONCLUSIONS
  Patients with CKD exhibit a hitherto unappreciated high prevalence of platelet hyperaggregability indicating sticky platelet syndrome. Laboratory testing of platelet hyperaggregability may supplement the assessment of thromboembolic complications in patients with CKD.
authors.affiliation: Laboratory Diagnostics Center, RWTH-University Hospital Aachen, Aachen and Medical Care Center, Dr Stein and colleagues, Mönchengladbach, Germany.
authors.forename: Eray
authors.initials: E
authors.lastname: Yagmur
authors.affiliation: Clinic for Internal Medicine and Clinical Intensive Care Medicine, Sankt Antonius Hospital Eschweiler, Eschweiler, Germany.
authors.forename: Rolf Dario
authors.initials: RD
authors.lastname: Frank
authors.affiliation: Department of Gynecological Endocrinology and Reproductive Medicine, RWTH-University Hospital Aachen, Aachen, Germany.
authors.forename: Joseph
authors.initials: J
authors.lastname: Neulen
authors.affiliation: Division of Nephrology and Clinical Immunology, RWTH-University Hospital Aachen, Aachen, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Floege
authors.affiliation: Division of Nephrology and Clinical Immunology, RWTH-University Hospital Aachen, Aachen, Germany amuehlfeld@ukaachen.de.
authors.forename: Anja Susanne
authors.initials: AS
authors.lastname: Mühlfeld
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D012307:Risk Factors; D013923:Thromboembolism / Q000097:blood* / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy
keywords: chronic kidney disease; embolism; platelet hyperaggregability; sticky platelet syndrome; thrombosis