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

E Michalak; B Walkowiak; M Paradowski; C S Cierniewski

doi:10.1055/s-0038-1647445

Thrombosis and Haemostasis, Table of Contents

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

Abstract

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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.

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References

References
1 Larrson S. On coagulation and fibrinolysis. Scand J Haematol 1971; (Suppl. 15) 1-59
2 Deykin D. Uremic bleeding. Kid Int 1983; 24: 689-705
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
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
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
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
7 Karpatkin S. Heterogeneity of human platelets. VI. Correlation of platelet function with platelet volume. Blood 1978; 51: 307-316
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
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
10 Eknoyan G, Brown CH. Biochemical abnormalities of platelets in renal failure. Am J Nephrol 1981; 1: 17-23
11 Smith MC, Dunn MJ. Impaired platelet thromboxane production in renal failure. Nephron 1981; 29: 133-137
12 Schultz J, Thom R. Electrical sizing and counting of platelets in whole blood. Med Biol Eng 1973; 11: 447-454
13 Groner C, Tycko R. Characterizing blood cells by biophysical measurements in flow. Blood Cells 1980; 6: 141-157
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
15 Nackeff A, Ingram M. Platelet count: volume relationship in four mammalian species. J Appl Physiol 1970; 28: 530-534
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
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
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
19 Thompson CB, Jakubowski JA. The pathophysiology and clinical relevance of platelet heterogeneity. Blood 1988; 72: 1-8
20 O’Brien JR, Jamieson S. A relationship between platelet volume and platelet number. Thromb Diath Haemorrh 1974; 31: 363-365
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
22 Mazur EM. Megakaryocytopoiesis and platelet production. Exp Hematol 1987; 15: 340-350
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
24 Paulus JM. Platelet size in man. Blood 1975; 46: 321-336
25 Trowbridge EA, Martin JF, Slater DN, Kishk YT, Warren CW. Platelet production: a computer based biological interpretation. Thromb Res 1983; 31: 329-350
26 Goles GA. Body composition in chronic renal failure. Quart J Med 1972; 41: 25-29
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
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
30 Flolt JC, Niewiarowski S. Biochemistry of a-granule proteins. Sem Hematol 1985; 22: 151-163
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
32 Kurihara Y, Nakayama H, Nagawa S. Plasma p-thromboglobulin and platelet factor 4 in renal insufficiency. Thromb Res 1980; 18: 557-560
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
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
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
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
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
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
39 Callen IR, Limarzi LR. Blood and bone marrow studies renal diease. Am J Clin Pathol 1950; 20: 3-23
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
41 Stewart JH. Platelet number and its life span in acute and chronic renal failure. Thromb Diath Haemorrh 1967; 17: 532-542
42 Castaldi P, Rozenberg MC, Stewart JH. The bleeding disorder of uremia. Lancet 1966; 2: 66-69
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
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
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
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
47 Bommer J, Muller-Buhl E, Ritz E, Eifert J. Recombinant human erythropoietin in anaemic patients on haemodialysis. Lancet 1987; 1: 392-394
48 Clark DA, Dessypris EN. Effect of recombinant erythropoietin on murine megakaryocyte colony formation in vitro. J Lab Clin Invest 1986; 108: 423-429
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
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
51 Ishibashi T, Koziol J, Burstein SA. Human recombinant erythropoietin promotes differentiation of murine megakaryocytes in vitro. J Clin Invest 1987; 79: 286-289
52 Burstein SA, Ishibashi T. Erythropoietin and megakaryocytopoiesis. Blood Cells 1989; 15: 193-201
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
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
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
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