Shahida Mohsin, Mahtab Aslam, Anees M, Shabbir Hussain, Tanvir Ahmed, Usman Qamar, Shabbir hussain.
Platelets dysfunction in patients of end stage renal disease.
Biomedica Jan ;26(2):157-61.

Introduction: Patients with end – stage renal disease (ESRD) develop increased bleeding ten-dency, which is characterized by defective interaction of platelets with damaged sub endothelium due to impaired platelet functions. This study was carried out to demonstrate the aggregation defects in uraemic patients by using different platelet agonists. Materials and Methods: A total of 57 subjects were included in the study. These were divided into two groups; 37 patients of ESRD on maintenance haemodialysis and 20 healthy adults as control. Complete blood count (CBC), urea and creatinine were carried out on all the samples. Aggregation studies were performed using chronology 490 – 2D Platelet Aggregometer. Adenosine diphosphate (ADP), collagen, ristocetin and arachidonic acid were used as agonists to perform aggregation studies and correlation of these parameters with Haemoglobin (Hb), Haematocrit (Hct), urea and creatinine were determined. Results: All the subjects included in this study were evaluated for platelet aggregation in vitro. Percentages of maximal aggregation of platelets with ADP, collagen, ristocetin and arachidonic acid were significantly low in uraemic patients as compared to the control group. Aggregation with ristocetin was particularly reduced in uraemic patients (Mean 57.54 ± 23.85%) in comparison with controls (Mean 84 ± 6.01%). Inverse correlation of urea was found with ADP response (p value 0.028) and creatinine with arachidonic acid (p value 0.036) which was statistically signifi-cant. No correlation was found between haemoglobin, haematocrit and percentage of maximal ag-gregation after stimulation with collagen, ADP, ristocetin and arachidonic acid. Aggregation res-ponses were reduced with almost all the agonists, especially ristocetin as compared to control sam-ples. Conclusion: This shows that defective platelet – vessel wall interactions play an important role in uraemic bleeding tendency.

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