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. 1972 Sep;25(9):745–753. doi: 10.1136/jcp.25.9.745

A clinical and experimental study of platelet function in chronic renal failure

E P Evans 1,2, R A Branch 1,2,1, A L Bloom 1,2,2
PMCID: PMC477502  PMID: 5086216

Abstract

Coagulation and platelet function studies were performed on 24 normal subjects and 29 patients with chronic renal failure due to various causes. Thrombocytopenia was uncommon in the uraemic patients but there was reduced platelet retention in glass bead columns and platelet aggregation with adenosine diphosphate (ADP) and thrombin was slower and less complete than normal. The rate of platelet disaggregation in uraemic patients was significantly reduced. The abnormalities tended to be more severe in more uraemic subjects. In normal subjects no inter-relationships were observed between the various measurements of platelet activity. In patients there were significant interrelationships between the measurements of platelet aggregation with ADP and thrombin and between the measurements of aggregation and retention in glass bead columns. It is suggested that if a common pathway is involved in these reactions it is adversely affected in uraemia.

Plasma coagulation defects were uncommon and present in only five of the uraemic subjects. Impaired prothrombin consumption apparently due to defective platelet function was present in half the patients but was not detected by a kaolin activation method. Although platelet coagulation function was activated during ADP aggregation and disaggregation in normal and uraemic subjects, it did not correlate in the latter with impairment of aggregation. It is suggested that aggregation and activation of platelet coagulant activity are not necessarily related aspects of platelet function. An effect of uraemic plasma on normal platelets was demonstrated by mixing experiments consistent with a humoral cause for the uraemic platelet defects.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bloom A. L., Evans E. P. Relationship of platelet retention in glass bead columns to the rate of aggregation with adenosine diphosphate and thrombin. J Clin Pathol. 1969 Sep;22(5):560–562. doi: 10.1136/jcp.22.5.560. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Castaldi P. A., Rozenberg M. C., Stewart J. H. The bleeding disorder of uraemia. A qualitative platelet defect. Lancet. 1966 Jul 9;2(7454):66–69. doi: 10.1016/s0140-6736(66)91802-2. [DOI] [PubMed] [Google Scholar]
  3. Eknoyan G., Wacksman S. J., Glueck H. I., Will J. J. Platelet function in renal failure. N Engl J Med. 1969 Mar 27;280(13):677–681. doi: 10.1056/NEJM196903272801301. [DOI] [PubMed] [Google Scholar]
  4. FERGUSON J. H., LEWIS J. H., ZUCKER M. B. Bleeding tendency in uremia. Blood. 1956 Dec;11(12):1073–1076. [PubMed] [Google Scholar]
  5. Gan I. E., Firkin B. G. Adenosine diphosphate (ADP) breakdown in human plasma with reference to platelet aggregation and uraemia. Thromb Diath Haemorrh. 1968 Jul 31;19(3):438–450. [PubMed] [Google Scholar]
  6. HARDISTY R. M., HUTTON R. A. THE KAOLIN CLOTTING TIME OF PLATELET-RICH PLASMA: A TEST OF PLATELET FACTOR-3 AVAILABILITY. Br J Haematol. 1965 May;11:258–268. doi: 10.1111/j.1365-2141.1965.tb06586.x. [DOI] [PubMed] [Google Scholar]
  7. HASLAM R. J. ROLE OF ADENOSINE DIPHOSPHATE IN THE AGGREGATION OF HUMAN BLOOD-PLATELETS BY THROMBIN AND BY FATTY ACIDS. Nature. 1964 May 23;202:765–768. doi: 10.1038/202765a0. [DOI] [PubMed] [Google Scholar]
  8. HELLEM A., OWREN P. A. THE MECHANISM OF THE HEMOSTATIC FUNCTION OF BLOOD PLATELETS. Acta Haematol. 1964 Apr;31:230–238. doi: 10.1159/000209632. [DOI] [PubMed] [Google Scholar]
  9. Hardisty R. M., Hutton R. A. Platelet aggregation and the availability of platelet factor 3. Br J Haematol. 1966 Nov;12(6):764–776. doi: 10.1111/j.1365-2141.1966.tb00164.x. [DOI] [PubMed] [Google Scholar]
  10. Hassanein A. A., McNicol G. P., Douglas A. S. Relationships between platelet function tests in normal and uraemic subjects. J Clin Pathol. 1970 Jul;23(5):402–406. doi: 10.1136/jcp.23.5.402. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Holdrinet A., Ewals M., Haanen C. Platelet function and von Willebrand's disease. Lancet. 1968 May 25;1(7552):1150–1150. doi: 10.1016/s0140-6736(68)90210-9. [DOI] [PubMed] [Google Scholar]
  12. Horowitz H. I., Cohen B. D., Martinez P., Papayoanou M. F. Defective ADP-induced platelet factor 3 activation in uremia. Blood. 1967 Sep;30(3):331–340. [PubMed] [Google Scholar]
  13. Hutton R. A., O'Shea M. J. Haemostatic mechanism in uraemia. J Clin Pathol. 1968 May;21(3):406–411. doi: 10.1136/jcp.21.3.406. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. MARSH W. H., FINGERHUT B., MILLER H. AUTOMATED AND MANUAL DIRECT METHODS FOR THE DETERMINATION OF BLOOD UREA. Clin Chem. 1965 Jun;11:624–627. [PubMed] [Google Scholar]
  15. PROCTOR R. R., RAPAPORT S. I. The partial thromboplastin time with kaolin. A simple screening test for first stage plasma clotting factor deficiencies. Am J Clin Pathol. 1961 Sep;36:212–219. doi: 10.1093/ajcp/36.3.212. [DOI] [PubMed] [Google Scholar]
  16. RATNOFF O. D., MENZIE C. A new method for the determination of fibrinogen in small samples of plasma. J Lab Clin Med. 1951 Feb;37(2):316–320. [PubMed] [Google Scholar]
  17. Rabiner S. F., Molinas F. The role of phenol and phenolic acids on the thrombocytopathy and defective platelet aggregation of patients with renal failure. Am J Med. 1970 Sep;49(3):346–351. doi: 10.1016/s0002-9343(70)80026-2. [DOI] [PubMed] [Google Scholar]
  18. Rozenberg M. C., Firkin B. G. The rate of platelet aggregation in haemorrhagic disease and thrombosis. Scand J Haematol. 1966;3(1):5–18. [PubMed] [Google Scholar]
  19. Salzman E. W., Chambers D. A., Neri L. L. Possible mechanism of aggregation of blood platelets by adenosine diphosphate. Nature. 1966 Apr 9;210(5032):167–169. doi: 10.1038/210167a0. [DOI] [PubMed] [Google Scholar]
  20. Salzman E. W., Neri L. L. Adhesiveness of blood platelets in uremia. Thromb Diath Haemorrh. 1966 Jan 31;15(1):84–92. [PubMed] [Google Scholar]
  21. de Vries S. I., ten Cate J. W., den Hartog-Veerman M. E., van Dooren M. M. Quelques remarques sur la thrombocytopathie acquise chez les malades urémiques. Schweiz Med Wochenschr. 1968 Oct 19;98(42):1658–1660. [PubMed] [Google Scholar]

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