Figure 5.

Mechanism of thrombosis in hemodialysis. (A) Contact between FXII and artificial surface activated the intrinsic pathway, which promoted thrombin production, resulting in enhanced coagulation. The negative charge on the artificial surface might contribute to the activation of FXII. (B) Contact between platelets and artificial surfaces induced platelet degranulation, PS exposure, PS-positive MP shedding, and glycoprotein loss. These effects eventually led to platelet activation and leukocyte, RBC, and platelet aggregation. (C) Hemodialysis cleared uremic toxins that induced platelet dysfunction, which promoted platelet activation. (D) Roller pump in the extracorporeal circuit induces the formation of microbubbles which promoted platelet activation. MP, microparticle; PS, phosphatidylserine; RBC, red blood cell.