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Changes in platelet function during hemodialysis

R D Levin, H C Kwaan, P Ivanovich

    The Journal of Laboratory and Clinical Medicine
    |November 1, 1978
    PubMed
    Summary
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    Hemodialysis impairs platelet function due to contact with dialyzer fibers and blood flow dynamics. While platelets show reduced aggregation, most are not irreversibly damaged during the procedure.

    Area of Science:

    • Nephrology
    • Hematology
    • Biomedical Engineering

    Background:

    • Platelet dysfunction is a concern during hemodialysis.
    • Understanding the impact of hemodialyzers on platelet function is crucial for patient safety.

    Purpose of the Study:

    • To investigate platelet function during hemodialysis using a specific hollow fiber hemodialyzer.
    • To assess the effects of anticoagulation with porcine mucosal heparin on platelet activity.

    Main Methods:

    • Studied 34 patients undergoing 74 hemodialysis sessions with a Cordis-Dow hollow fiber hemodialyzer (CDAK-4).
    • Measured platelet levels and aggregation using platelet aggregometry.
    • Analyzed platelet concentrations in afferent and efferent limbs of the dialyzer.

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    Main Results:

    • Mean arterial platelet levels decreased by 11% but remained stable during the 5-hour session.
    • Platelet concentration was similar in both dialyzer limbs after 30 minutes, with leukocyte retention observed.
    • Heparin potentiated ADP-induced aggregation; however, platelets showed reduced aggregability post-dialysis, requiring higher stimuli.

    Conclusions:

    • Direct contact with dialyzer fibers and rheological effects impair platelet function during hemodialysis.
    • Most platelets are not irreversibly injured, suggesting potential for recovery.
    • Findings highlight the need for careful consideration of dialyzer materials and hemodynamics on platelet integrity.