Does Hemodialysis Need to be Initiated to Improve Platelet Function in CKD G5 Patients? A Pilot Prospective, Observational Cohort Study
| Autor: | Anna T Valson, Shibu Jacob, Shailesh Kakde, Santosh Varughese, Anjali Mohapatra, Vinod B Murakonda, Ramya Vijayan, Sukesh C. Nair, Suceena Alexander, Tulasi Geevar, Vinoi George David |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
CKDG5
Light transmission medicine.medical_specialty Collagen adenosine diphosphate medicine.medical_treatment platelet function 030232 urology & nephrology 030230 surgery lcsh:RC870-923 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Platelet Stage (cooking) hemodialysis business.industry lcsh:Diseases of the genitourinary system. Urology medicine.disease PFA 200 Nephrology Cardiology Observational study Original Article Aggregometry Hemodialysis business Kidney disease Cohort study |
| Zdroj: | Indian Journal of Nephrology Indian Journal of Nephrology, Vol 31, Iss 1, Pp 43-49 (2021) |
| ISSN: | 1998-3662 0971-4065 |
| Popis: | Introduction: We previously showed that patients with chronic kidney disease (CKD) Stage G4-5 have normal bleeding times. This made us question whether hemodialysis (HD) initiation was really necessary solely to improve platelet function. Methods: In this prospective observational study, two 5 ml citrated blood samples and one 2 ml EDTA blood sample were collected from incident HD patients fulfilling inclusion criteria prior to HD initiation (baseline sample) and after three sessions of short duration, low flow, counter-current HD. In each instance, one sample was used to perform Collagen adenosine diphosphate closure time (CADPCT) using the Platelet function analyzer (PFA 200, normal range 68-142 seconds) and the second for light transmission aggregometry (LTA) with ADP as agonist (normal ≥50%). Results: This study included 20 patients between October 2017 and February 2019. Overall, and in the subgroup with normal baseline CADPCT or LTA, there was no statistically significant improvement after HD. However, of the 30% of patients who had an abnormal baseline CADPCT, 50% attained a normal value after three HD sessions, and the overall reduction in CADPCT in this group was statistically significant (P = 0.02). Of those with a baseline normal CADPCT, 21% developed abnormal prolongation post HD. Conclusion: HD for the sole purpose of improving platelet function is only of benefit in the subgroup of patients with an abnormal CADPCT at baseline, with close to 50% normalizing their platelet function after three sessions of low flow, short duration, counter-current HD. |
| Databáze: | OpenAIRE |
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