In vivo platelet hyperreactivity, another risk factor for patients under continuous ambulatory peritoneal dialysis

A high mortality rate due to thromboembolic accidents has been described in patients undergoing chronic haemodialysis. This type of complications, although recognized, has not been appropriately evaluated in continuous ambulatory peritoneal dialysis patients. The present study demonstrates that continuous ambulatory peritoneal dialysis patients present in vivo platelet hyperreactivity, as evidenced by enhanced platelet responses to epinephrine ex vivo and an increased MDA/MDAa index which traduces a decreased threshold for activation of the arachidonate pathway and subsequent thromboxane production. Since the etiopathogeny of this platelet abnormality seems to be related to abnormalities in lipid metabolism, compounds such as fish oil must be beneficial in the management of this risk factor.