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Semin Thromb Hemost 2004; 30(5): 579-589
DOI: 10.1055/s-2004-835678
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Platelet Dysfunction in Renal Failure

Paola Boccardo1 , Giuseppe Remuzzi1 , 2 , Miriam Galbusera1
  • 1Mario Negri Institute for Pharmacological Research, Azienda Ospedaliera, Ospedali Riuniti di Bergamo, Bergamo, Italy
  • 2Director, Unit of Nephrology and Dialysis, Azienda Ospedaliera, Ospedali Riuniti di Bergamo, Bergamo, Italy
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Publikationsverlauf

Publikationsdatum:
21. Oktober 2004 (online)

    Lizenzen und Reprints

Patients with end-stage renal disease suffer from complex hemostatic disorders. Uremic patients show a bleeding diathesis that is mainly due to abnormalities of primary hemostasis; in particular, platelet dysfunction and impaired platelet-vessel wall interaction. However, despite decreased platelet function, these patients have a high prevalence of cardiovascular and thrombotic complications. Platelet dysfunction in uremic patients is partially due to uremic toxins present in circulating blood. Dialysis improves platelet abnormalities and reduces, but does not eliminate, the risk of hemorrhage. Hemodialysis can even contribute to the bleeding through the continuous platelet activation induced by the interaction between blood and artificial surfaces. Thrombocytopenia, glomerular thrombosis, and thrombi in small arteries and glomerular capillaries are common pathological features in many renal diseases. Platelets are also involved directly in the pathogenesis of glomerular diseases through a variety of mechanisms, including release of active molecules, by enhancing immune complex deposition, and by altering glomerular permeability.

KEYWORDS

Platelet - renal diseases - uremia - bleeding - thrombosis

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Giuseppe RemuzziM.D. F.R.C.P. 

Mario Negri Institute for Pharmacological Research, Via Gavazzeni 11

24125 Bergamo, Italy

eMail: manuelap@marionegri.it