Key result
Hemodialysis shortens platelet closure time in ESRD, normalizing it in ~22% of prolonged cases.
Why the study?
Does hemodialysis improve platelet function measured by closure time in patients with end-stage renal disease?
Observational (n=60)
Does hemodialysis improve platelet function measured by closure time in patients with end-stage renal disease?
p-value: p=0.004
Hemodialysis partially corrects platelet dysfunction in patients with end-stage renal disease, as evidenced by improved closure times.
Hemodialysis-associated shortening of closure time warrants no practice change; leaves open effects on bleeding risk in ESRD.
In patients with end-stage renal disease (ESRD), hemorrhagic complications are commonly encountered due to abnormalities in primary hemostasis, in particular, platelet (PLT) dysfunction and impaired PLT-vessel wall interaction. The pathogenesis of altered PLT function is considered multifactorial. Dialysis procedures had a favorable impact on bleeding complications in uremic patients. We aimed to evaluate the effect of hemodialysis on PLT function in patients with ESRD on a regular hemodialysis program. This study was carried on 40 ESRD Egyptian patients undergoing regular hemodialysis. Twenty healthy subjects were studied as a control group. Samples were assayed for PLT function by PLT function analyzer-100 (PFA-100) before and after the hemodialysis session. Prolonged closure time (CT) was found in 90% of patients before hemodialysis session and returned to normal ranges after hemodialysis session in 22% of those patients. The CT was longer among patients before and after hemodialysis session compared to controls (p < 0.01 and p = 0.02, respectively), while it was shorter among patients after hemodialysis session compared to before hemodialysis session (p = 0.004). Hemoglobin (Hb) level and hematocrit (Hct) values were higher in control group compared to patient group before hemodialysis session (p < 0.01 and p = 0.001, respectively), patients after hemodialysis session (p < 0.01 and p = 0.02, respectively) and also in patients after hemodialysis compared to before hemodialysis session (p = 0.001 and p < 0.01, respectively). The percentage change in PLT count was positively correlated with that of Hb (p = 0.01). We concluded that PLT dysfunction is encountered in ESRD Egyptian patients, and hemodialysis has the ability to correct some part of these hemostatic disturbances.
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Mekawy et al. (2014) conducted an observational in End-stage renal disease (n=60). Hemodialysis vs. Before hemodialysis / Healthy controls was evaluated on Platelet function (closure time) (p=0.004). Hemodialysis significantly shortened platelet closure time in ESRD patients compared to pre-dialysis levels (p=0.004), normalizing it in 22% of patients with initially prolonged times.
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