Platelet function in dialyzed and non-dialyzed patients with chronic renal failure

Platelet function studies were performed on healthy volunteers, patients with stable chronic renal failure, hospital dialysis patients and home dialysis patients. In the non-dialyzed patients with chronic renal failure, there was inverse exponential relationship between serum creatinine and platelet adhesiveness indicating progressive impairment of platelet adhesiveness with creatinines in excess of 6 mg/100 ml. In the dialysis population there was an inverse linear relationship between platelet adhesiveness and pre-dialysis creatinine values. Platelet aggregation by ADP was normal in chronic renal failure patients with serum creatinines less than 6 mg/100 ml but was impaired in others. Both groups of dialysis patients also had impaired platelet aggregation but improvement appears obtainable by home dialysis. The results suggest that in chronic renal failure, platelet function is normal until serum creatinine exceeds 6 mg/100 ml and thereafter progressively deteriorates. Improvement is not obtained by 12 m2 hours of hospital dialysis but is by 18 m2 hours per week of home dialysis. Platelet function studies may be of value in assessing the adequacy of dialysis.