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Elevated thrombocyte calcium content in uremia and its correction by 1 alpha(OH) vitamin D treatment
Insights
Uremic patients exhibit elevated platelet calcium levels, impairing platelet function. Treatment with an active vitamin D metabolite, 1 alpha (OH) vitamin D, significantly reduced these calcium levels, suggesting a therapeutic benefit for uremic platelet dysfunction.
Area of Science:
- Nephrology
- Hematology
- Biochemistry
Background:
- Intracellular calcium regulates platelet function.
- Platelet function is impaired in uremia, potentially due to elevated intracellular calcium.
- Uremia is associated with impaired organ function, possibly linked to calcium dysregulation.
Purpose of the Study:
- To determine if thrombocyte (platelet) calcium content is elevated in uremic patients.
- To investigate whether treatment with an active vitamin D metabolite can correct elevated platelet calcium in uremia.
Main Methods:
- Platelet calcium content was measured in 10 chronic hemodialysis patients and 20 healthy controls.
- A technique involving consecutive freezing and thawing of platelet-rich plasma was used for calcium determination.
- Patients received 1 alpha (OH) vitamin D (0.5-2.5 microgram/day) for one month.
Main Results:
- Uremic patients showed significantly higher platelet calcium content (20.86 ng/200,000 platelets) compared to normals (12.8 ng/200,000 platelets).
- After one month of 1 alpha (OH) vitamin D treatment, platelet calcium levels in dialysis patients decreased significantly (14.99 ng/200,000 platelets).
Conclusions:
- Platelet calcium content is markedly elevated in patients undergoing chronic hemodialysis.
- Treatment with 1 alpha (OH) vitamin D can significantly reverse this elevation in platelet calcium.
- Elevated platelet calcium may contribute to the pathogenesis of uremic platelet dysfunction, and vitamin D therapy may be beneficial.
Abstract:
Intracellular calcium plays an important role in the regulation of platelet function. It has also been demonstrated that platelet functions are impaired in uremia. A rise in intracellular calcium has been shown in several tissues and has been held responsible for the impaired function of several organs seen in uremia. This study was undertaken to evaluate whether the calcium (Ca) content of thrombocytes is elevated in uremia and, if so whether treatment with an active vitamin D metabolite might correct this abnormality. In 10 patients on chronic hemodialysis, platelet Ca content was determined by a technique utilizing consecutive freezing and thawing of platelet-rich plasma. The platelet Ca content of uremic patients was found to be markedly higher (20.86 +/- 0.9 ng/200,00 platelets, p less than 0.01) than that of a group of 20 normals (12.8 +/- 1.2 ng/200,000 platelets). 1 months after treatment with 1 alpha (OH) vitamin D at a dosage of 0.5-2.5 microgram/day, the platelet Ca content of the dialysis patients decreased to 14.99 +/- 2.14 ng/200,000 platelets (p less than 0.05). The data show that in dialysis patients the platelet Ca content is markedly elevated in comparison with that of normals, and the treatment with 1 alpha (OH) vitamin D may significantly reverse this abnormality. It is suggested that elevated Ca content may play a role in the pathogenesis of uremic platelet dysfunction, and that 1 alpha (OH) vitamin D administration may be of benefit in correcting this disorder.