Download PDF
Thromb Haemost 1991; 65(01): 011-014
DOI: 10.1055/s-0038-1647445
Original Article
Schattauer GmbH Stuttgart

The Decreased Circulating Platelet Mass and Its Relation to Bleeding Time in Chronic Renal Failure

E Michalak
*   The Department of Nephrology, Military Medical School, Lodz, Poland
,
B Walkowiak
**   The Department of Biophysics, Military Medical School, Lodz, Poland
,
M Paradowski
***   The Department of Medical School, Laboratory Unit, Military Medical School, Lodz, Poland
,
C S Cierniewski
**   The Department of Biophysics, Military Medical School, Lodz, Poland
› Author Affiliations
Further Information

Publication History

Received 06 October 1989

Accepted after revision 21 August 1990

Publication Date:
02 July 2018 (online)

Also available at
  PDF Download  Permissions and Reprints

Summary

The mean platelet volume, measured optically and by the electrical impedance method, was analysed in the patients with chronic renal failure. All parameters describing the circulating platelet biomass except the platelet volume heterogeneity were decreased in these patients. There is a strong inverse relation between the Ivy bleeding time and the platelet mass in the patient group.

Our results indicate that the smaller platelets circulating in the patients with chronic renal failure may contribute to the uremic bleeding diathesis, and disturbed thrombocytopoiesis occurs in chronic renal failure.

 

  • References

  • 1 Larrson S. On coagulation and fibrinolysis. Scand J Haematol 1971; (Suppl. 15) 1-59
    PubMedGoogle Scholar
  • 2 Deykin D. Uremic bleeding. Kid Int 1983; 24: 689-705
    PubMedGoogle Scholar
  • 3 Di Minno G, Cerbone A, Usberti M, Cianciaruso B, Cortese A, Farace MJ, Martinez J, Murphy S. Platelet dysfunction in uremia. Correction by arachidonic acid of the impaired exposure of fibrinogen receptors by ADP and collagen. J Lab Clin Med 1986; 108: 246-252
    PubMedGoogle Scholar
  • 4 Castillo RA, Lozano T, Escolar G, Revert L, Lopez J, Ordinas A. Defective platelet adhesion on vessel subendothelium in uremic patients. Blood 1986; 2: 337-342
    PubMedGoogle Scholar
  • 5 Thompson CAB, Jakubowski JA, Quinn PG, Deykin D, Valeri CR. Platelet size as a determinant of platelet function. J Lab Clin Med 1983; 101: 205-213
    PubMedGoogle Scholar
  • 6 Karpatkin S. Heterogeneity of human platelets. I. Metabolic and kinetic evidence suggestive of young and old platelets. J Clin Invest 1969; 48: 1073-1082
    CrossrefPubMedGoogle Scholar
  • 7 Karpatkin S. Heterogeneity of human platelets. VI. Correlation of platelet function with platelet volume. Blood 1978; 51: 307-316
    PubMedGoogle Scholar
  • 8 Thompson CAB, Eaton CAB, Thompson K, Princiotta S, Ryskin V, Valeri C. Size-dependent platelet subpopulations: relationship of platelet volume to ultrastructure, enzymatic activity and function. Br J Haematol 1982; 50: 509-519
    CrossrefPubMedGoogle Scholar
  • 9 Eldor A, Avitzour M, Or R, Hanna R, Penchas S. Prediction of haemorrhagic diathesis in thrombocytopenia by mean platelet volume. Br Med J 1982; 285: 397-400
    CrossrefPubMedGoogle Scholar
  • 10 Eknoyan G, Brown CH. Biochemical abnormalities of platelets in renal failure. Am J Nephrol 1981; 1: 17-23
    CrossrefPubMedGoogle Scholar
  • 11 Smith MC, Dunn MJ. Impaired platelet thromboxane production in renal failure. Nephron 1981; 29: 133-137
    CrossrefPubMedGoogle Scholar
  • 12 Schultz J, Thom R. Electrical sizing and counting of platelets in whole blood. Med Biol Eng 1973; 11: 447-454
    CrossrefPubMedGoogle Scholar
  • 13 Groner C, Tycko R. Characterizing blood cells by biophysical measurements in flow. Blood Cells 1980; 6: 141-157
    PubMedGoogle Scholar
  • 14 Trowbridge EA, Reardon DM, Hutchinson D, Pickering C. The routine measurement of platelet volume: a comparison of light-scattering and aperture-impedance technologies. Clin Physiol Meas 1985; 6: 221-238
    CrossrefPubMedGoogle Scholar
  • 15 Nackeff A, Ingram M. Platelet count: volume relationship in four mammalian species. J Appl Physiol 1970; 28: 530-534
    CrossrefPubMedGoogle Scholar
  • 16 Mielke CH, Kaneshiro MM, Maher IA, Weiner JM, Rapaport SAI. The standarized normal Ivy bleeding time and its prolongation by aspirin. Blood 1969; 34: 204-215
    PubMedGoogle Scholar
  • 17 Ivy AC, Nelson D, Bucher G. The standardization of certain factors in the cutaneous “venostasis” bleeding technique. J Lab Clin Med 1941; 26: 1812-1822
    PubMedGoogle Scholar
  • 18 Martin JF, Trowbridge EA. The biological significance of platelet volume: its relationship to bleeding time, platelet tromboxane B2 production and megakaryocyte nuclear DNA content. Thromb Res 1983; 32: 443-460
    CrossrefPubMedGoogle Scholar
  • 19 Thompson CB, Jakubowski JA. The pathophysiology and clinical relevance of platelet heterogeneity. Blood 1988; 72: 1-8
    CrossrefPubMedGoogle Scholar
  • 20 O’Brien JR, Jamieson S. A relationship between platelet volume and platelet number. Thromb Diath Haemorrh 1974; 31: 363-365
    PubMedGoogle Scholar
  • 21 Bessmann JD, Wiliams LJ, Gilmer PR. Mean platelet volume. The inverse relation of platelet size and count in normal subjects and an artifact of other particles. Am J Clin Pathol 1981; 76: 289-293
    CrossrefPubMedGoogle Scholar
  • 22 Mazur EM. Megakaryocytopoiesis and platelet production. Exp Hematol 1987; 15: 340-350
    PubMedGoogle Scholar
  • 23 Furuta I, Ohba Y, Akiyama T, Okada K, Takenaka K. Studies on platelet volume distribution in various diseases. Acta Med Kinki Univ 1979; 4: 205-211
    PubMedGoogle Scholar
  • 24 Paulus JM. Platelet size in man. Blood 1975; 46: 321-336
    PubMedGoogle Scholar
  • 25 Trowbridge EA, Martin JF, Slater DN, Kishk YT, Warren CW. Platelet production: a computer based biological interpretation. Thromb Res 1983; 31: 329-350
    CrossrefPubMedGoogle Scholar
  • 26 Goles GA. Body composition in chronic renal failure. Quart J Med 1972; 41: 25-29
    PubMedGoogle Scholar
  • 25 Knochel JP, Seldin DW. The pathophysiology of uremia. In: The Kidney. Second Edition Brenner BM, Rector FC. (eds) W. B. Saunders Company; Philadelphia: 1981: 2137-2183
  • 28 Cole CH, Balfe JW, Welt LG. Induction of a ouabain-sensitive ATP-ase defect by uremic plasma. Trans Assoc Am Physicians 1986; 81: 213-220
    PubMedGoogle Scholar
  • 29 van Oost BA, Timmermans AP, Sixma JJ. Evidence that platelet density depends on the a-granule content in platelets. Blood 1984; 63: 482-485
    PubMedGoogle Scholar
  • 30 Flolt JC, Niewiarowski S. Biochemistry of a-granule proteins. Sem Hematol 1985; 22: 151-163
    PubMedGoogle Scholar
  • 31 Niewiarowski S, Holt JC. Platelet a-granule proteins: biochemical and pathological aspects. In: The Platelets: Physiology and Pharmacology Acad Press; New York: 1985: 49-83
    Google Scholar
  • 32 Kurihara Y, Nakayama H, Nagawa S. Plasma p-thromboglobulin and platelet factor 4 in renal insufficiency. Thromb Res 1980; 18: 557-560
    CrossrefPubMedGoogle Scholar
  • 33 Doppermann D, Andrassy K, Seeling H, Ritz E, Dost D. Beta-thromboglobulin is elevated in renal failure without thrombosis. Thromb Res 1980; 17: 63-69
    CrossrefPubMedGoogle Scholar
  • 34 Andrassy K, Doppermann D, Ritz E, Koderish J, Seelig H. Different effect of renal failure on beta-thromboglobulin and high affinity platelet 4 (HA-PF 4) concentrations. Thromb Res 1980; 18: 469-475
    CrossrefPubMedGoogle Scholar
  • 35 Dawes J, Smith RG, Pepper DS. The release, distribution and clearence of human p-thromboglobulin and platelet factor 4. Thromb Res 1978; 12: 851-859
    CrossrefPubMedGoogle Scholar
  • 36 Vlachoiannis J, Schoeppe W. Adenylate cyclase activity and c-AMP content on human platelets in uremia. Eur J Clin Invest 1982; 12: 379-381
    CrossrefPubMedGoogle Scholar
  • 37 Jacobsson B, Rasnas L, Nyberg G, Bregh CH, Magnusson Y, Hjalmarson A. Abnormality of adenylate cyclase regulation in human platelet membranes in renal failure. Eur J Clin Invest 1985; 15: 75-81
    CrossrefPubMedGoogle Scholar
  • 38 Ware JA, Clark BA, Smith M, Saltzmann EW. Abnormalities of cytoplasmic Ca2+ in platelet from patients with uremia. Blood 1989; 73 (01) 172-176
    PubMedGoogle Scholar
  • 39 Callen IR, Limarzi LR. Blood and bone marrow studies renal diease. Am J Clin Pathol 1950; 20: 3-23
    CrossrefPubMedGoogle Scholar
  • 40 Gafter U, Bessler H, Malachi D, Zevin D, Djaldetti H, Levi J. Platelet count and thrombopoietic activity in patients with chronic renal failure. Nephron 1987; 45: 207-210
    CrossrefPubMedGoogle Scholar
  • 41 Stewart JH. Platelet number and its life span in acute and chronic renal failure. Thromb Diath Haemorrh 1967; 17: 532-542
    PubMedGoogle Scholar
  • 42 Castaldi P, Rozenberg MC, Stewart JH. The bleeding disorder of uremia. Lancet 1966; 2: 66-69
    PubMedGoogle Scholar
  • 43 Evatt BL, Spivak JL, Levin J. Relationship between thrombopoiesis and erythropoiesis; with studies of the effects of preparations of thrombopoietin and erythropoietin. Blood 1976; 48: 547-558
    PubMedGoogle Scholar
  • 44 Berridge HV, Fraser JK, Carter JM, Lin FK. Effect of recombinant human erythropoietin on megakaryocytes and platelet production in the rat. Blood 1988; 72: 970-977
    PubMedGoogle Scholar
  • 45 van GeetC, Hauglustaine D, Verresen L, Vanrusselt M, Vermylen J. Hemostatic effects of recombinant human erythropoietin in chronic renal failure. Thromb Haemostas 1989; 61: 117-121
    PubMedGoogle Scholar
  • 46 Zins B, Drueke T, Zingraff J, Bereri L, Kreis H, Naret C, Delons S, Castaigne JP, Peterlongo F, Casadevall N, Varet B. Erythropoietin treatment in anaemic patients on hemodialysis. Lancet 1986; 2: 1329-1331
    PubMedGoogle Scholar
  • 47 Bommer J, Muller-Buhl E, Ritz E, Eifert J. Recombinant human erythropoietin in anaemic patients on haemodialysis. Lancet 1987; 1: 392-394
    PubMedGoogle Scholar
  • 48 Clark DA, Dessypris EN. Effect of recombinant erythropoietin on murine megakaryocyte colony formation in vitro. J Lab Clin Invest 1986; 108: 423-429
    PubMedGoogle Scholar
  • 49 Dessypris EN, Gleaton JH, Armstrong OL. Effect of human recombinant erythropoietin on human marrow megakaryocyte colony formation in vitro. Br J Haematol 1987; 65: 265-269
    CrossrefPubMedGoogle Scholar
  • 50 Hoffman R, Straneva J, Yang HH, Bruno E, Brandt J. New insights into the regulation of human megakaryocytopoiesis. Blood Cells 1987; 13: 75-86
    PubMedGoogle Scholar
  • 51 Ishibashi T, Koziol J, Burstein SA. Human recombinant erythropoietin promotes differentiation of murine megakaryocytes in vitro. J Clin Invest 1987; 79: 286-289
    CrossrefPubMedGoogle Scholar
  • 52 Burstein SA, Ishibashi T. Erythropoietin and megakaryocytopoiesis. Blood Cells 1989; 15: 193-201
    PubMedGoogle Scholar
  • 53 van Doormal JJ, van der MeerJ, Oosten HR, Halie MA, Doorenbos H. Hypothyroidism leads to more small-sized platelets in circulation. Thromb Haemostas 1987; 58: 964-965
    PubMedGoogle Scholar
  • 54 Steiner RW, Coggins C, Carvalho A CA. Bleeding time in uremia : a useful test to assess clinical bleeding. Am J Haematol 1979; 7: 107-117
    CrossrefPubMedGoogle Scholar
  • 55 Szczeklik A, Milner PC, Birch J, Watkins J, Martin JF. Prolonged bleeding time, reduced platelet aggregation, altered PAF-acether sensitivity and increased platelet mass are a trait of asthma and hay fever. Thromb Haemostas 1986; 56 (03) 283-287
    PubMedGoogle Scholar
  • 56 Milner PC, Martin JF. Shortened bleeding time in acute myocardial infarction and its relation to platelet mass. Br Med J 1985 290: 1767-1770
    PubMedGoogle Scholar