Circulating platelet-derived microparticles with procoagulant activity may be a potential cause of thrombosis in uremic patients

Circulating platelet-derived microparticles with procoagulant activity may be a potential cause of thrombosis in uremic patients. Clinical experience indicates that bleeding and thrombotic tendencies co-exist in uremic patients. Numerous studies have shown that platelet functional defects contribute...

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Bibliographic Details
Published in:	Kidney international Vol. 62; no. 5; pp. 1757 - 1763
Main Authors:	Ando, Minoru, Iwata, Akiko, Ozeki, Yasushi, Tsuchiya, Ken, Akiba, Takashi, Nihei, Hirosh
Format:	Journal Article Conference Proceeding
Language:	English
Published:	New York, NY Elsevier Inc 01-11-2002 Nature Publishing Elsevier Limited
Subjects:	acute arterial occlusion Aged annexin V Arteriovenous Shunt, Surgical Biological and medical sciences bleeding tendency Blood Coagulation Blood Platelets - physiology Blood Platelets - ultrastructure Erythropoietin - administration & dosage flow cytometric analysis Flow Cytometry Humans Medical sciences Middle Aged Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Particle Size Peritoneal Dialysis, Continuous Ambulatory platelet function procoagulant activity Recombinant Proteins Renal Dialysis Renal failure thrombosis Thrombosis - etiology Thrombosis - physiopathology Uremia - complications Uremia - physiopathology Uremia - therapy thrombosis procoagulant activity flow cytometric analysis platelet function annexin V bleeding tendency acute arterial occlusion Kidney disease Human Urinary system disease Pathophysiology Cardiovascular disease Exploration Thrombosis Vascular disease Hemostasis Renal failure Platelet function Complication Uremia
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Summary:	Circulating platelet-derived microparticles with procoagulant activity may be a potential cause of thrombosis in uremic patients. Clinical experience indicates that bleeding and thrombotic tendencies co-exist in uremic patients. Numerous studies have shown that platelet functional defects contribute to the bleeding tendency in uremic patients. In contrast, there are no solid studies clarifying the pathogenesis of the prothrombotic state in uremic patients. Platelet-derived microparticles (PMPs), which are small vesicles with procoagulant activity released from activated platelets, are thought to be involved in clinical thrombogenesis. This study addressed the question of why uremic patients are thrombophilic even though they have a bleeding tendency, focusing on the clinical significance of PMPs. The subjects were pre-dialyzed patients, patients under hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) therapy, and age-matched healthy controls. Analyses of PMPs were performed using a flow cytometer. Annexin V was used to probe procoagulant activity of PMPs. The impacts of the HD procedure, arteriovenous (AV) fistula, and recombinant human erythropoietin (rHuEPO) treatment on the release of PMPs were additionally assessed. Major results are: (1) PMP counts were significantly greater in each uremic group than in controls. The PMP counts were not different among three types of uremic groups; (2) PMP counts were significantly higher in uremic patients with thrombotic events than in those without thrombotic events; and (3) the HD procedure and existence of AV fistula did not affect PMP counts, but rHuEPO treatment possibly enhanced the PMP release in these patients. Elevated PMP counts may trigger thrombosis in uremic patients. The primary cause of PMP elevation in uremia was not clarified in this study.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0085-2538 1523-1755
DOI:	10.1046/j.1523-1755.2002.00627.x