Impaired expression of glycoproteins on resting and stimulated platelets in uraemic patients

TLDR: Findings indicate that uraemic platelets are hyporesponsive to stimulation, compared with controls, which indicates that chronic renal failure patients with CRF are likely to have low platelet function.

Abstract: Background. The increased bleeding tendency of chronic renal failure (CRF) patients has been attributed to platelet dysfunction. However, reports on various platelet functions in uraemic patients have been conflicting. The present study sought to analyse platelet function by examining their surface glycoproteins in well-identified populations ofCRF patients. Methods. Three groups were studied: 22 chronic haemodialysis (HD) patients, 25 conservatively treated patients with CRF and 30 controls. Bleeding tendency was assessed by measuring bleeding time and by recording current haemorrhagic symptoms. We measured the fibrinogen receptor GPIIbIIIa, the von Willebrand receptor GPIb, and P-selectin levels on the platelet surface using flow cytometry. Results. Forty percent ofCRF and 45% ofHD patients had bleeding. The bleeding time was similar in the HD and CRF groups, but was longer in both groups than in controls. In resting platelets, GPIb expression was lower in CRF patients than in controls. In stimulated platelets (i) GPIb expression was higher in HD patients than in both controls and CRF patients; and (ii) GPIIbIIIa and P-selectin expression were lower in CRF and HD patients than in controls. Conclusions. These findings indicate that uraemic platelets are hyporesponsive to stimulation.