Kidney Week

Abstract: SA-PO398

Comparison of Platelet Aggregation Test before and after Hemodialysis in Patients with Kidney Failure

Session Information

• Hemodialysis and Frequent Dialysis - 2
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Konwai, Sirihatai, Nephrology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Please select, Thailand

Sirihatai Konwai

• Wongpraphairot, Suwikran, Nephrology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Please select, Thailand

Suwikran Wongpraphairot, MD

• Saelue, Pirun, Hematology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Please select, Thailand

Pirun Saelue

• Phongphithakchai, Atthaphong, Nephrology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Please select, Thailand

Atthaphong Phongphithakchai, MD

• Praditaukrit, Suntornwit, Nephrology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Please select, Thailand

Suntornwit Praditaukrit

Background

One of the important signs of uremic toxin accumulation in renal failure patient is uremic bleeding. Renal replacement therapy is the way to stop uremic bleeding. However, opinions on how hemodialyis affects platelet function in uremia patients are divided.

Methods

This prospective cohort study included patients initiating hemodialysis with a blood urea nitrogen level more than 60 mg/dL. Blood samples were collected before and after the first, second, third, and day thirty of hemodialysis for the platelet aggregation test. The The primary outcome was the platelet aggregation test results before and after hemodialysis. Secondary outcomes included 30-day mortality and events of bleeding.

Results

Of the 15 cases that were included, 53.3% were female.There were 10 patients with chronic renal failure. The median values for hemoglobin, platelet counts, and fibrinogen were 9.00 mg/dL, 240000/microliter, and 758.4 mg/dl. Comparing the thirty-day pre-dialysis with the first pre-dialysis session, there was a higher percentage of platelet aggregation in adenosine diphosphate (ADP) (difference in aggregation level was 9.76, 95% CI 1.93-17.60). The first pre-dialysis session and the thirty-day pre-dialysis session show a significant difference in the slope after stimulation with ADP and epinephrine (difference 28.03, 95%CI 13.67-42.39 and 38.96, 95% CI 14.64-63.29). There was no death or bleeding for thirty days.

Conclusion

ADP and epinephrine-related platelet aggregation can be improved by initiating hemodialysis at least two sessions in advance. Hemodialysis can therefore be utilized to prevent uremic bleeding.

Platelet aggregation stimulated by adenosine diphosphate
* Significant difference
MA: maximum of platelet aggregation
Slope: slope at 1st minute
Max slope: slope at time to maximum aggregation

Platelet aggregation stimulated by epinephrine
* Significant difference
MA: maximum of platelet aggregation
Slope: slope at 1st minute
Max slope: slope at time to maximum aggregation

Funding

• Private Foundation Support