Soonchunhyang Med Sci.  2013 Dec;19(2):80-86.

The Effect of Antiplatelet Agent on Platelet Function in End-stage Renal Disease

• Kim DY
• Park HS
• Han DJ
• Rhee HS
• Kim TW
• Jung SY
• Kim HJ
• Gil HW

Abstract

OBJECTIVE
Uremic bleeding is well recognized problem. In patients with renal failure, the safety of antiplatelet therapy is doubtful and there is little data about the platelet function in dialysis patients who are prescribed antiplatelet agents. The aim of this study is to investigate the platelet function in dialysis patients who were taking antiplatelet agents.
METHODS
The cross-sectional study was performed on 49 patients who have been undergoing dialysis (A group, 19 patients), normal renal function (B group, 30 patients). All of them have taken aspirin and clopidogrel. The control group (C group) consisted of 30 patients who have been undergoing dialysis, not taking aspirin or clopidogrel. The in-vitro closure time was measured using a PFA-100 device that had cartridges holding a membrane with a central aperture and this was coated with either collagen/epinephrine (CEPI) or collagen/adenosine diphosphate (CADP). In vitro closure time was measured by each cartridge defined CADP and CEPI.
RESULTS
The CADP and CEPI were higher in the patients with end stage renal disease (ESRD) and who were not taking dual blockers than the normal range (CADP: 80-162, CEPI: 64-121). CADP prolonged in A group compared to C group. Hemodialysis, platelet count <201x106/L, hematocrit, antiplatelet medication are relevant to the prolongation of CEPI and CADP in binary logistic regression analyses.
CONCLUSION
Platelet function in ESRD patients was deteriorated irrespective of antiplatelet medication, which became even worse if they took antiplatelet drugs. Therefore, we have to take careful attention to the increased bleeding tendency of ESRD patients due to the antiplatelet drugs.

Keyword

Aspirin; Clopidogrel; Chronic kidney failure; Uremia

MeSH Terms

Aspirin
Blood Platelets*
Cross-Sectional Studies
Dialysis
Hematocrit
Hemorrhage
Humans
Kidney Failure, Chronic*
Logistic Models
Membranes
Platelet Aggregation Inhibitors
Platelet Count
Reference Values
Renal Dialysis
Renal Insufficiency
Uremia
Aspirin
Platelet Aggregation Inhibitors