To study the qualitative platelet defect in hemostasis of chronic renal failure, we observed the platelet aggregation with platelet aggregometer and the platelet adhesiveness with glass bead columns in 40 chronic renal failure patients and 40 healthy persons.
In chronic renal failure, the platelet count was markedly decreased to 150,000±78,000/mm3 in contrast to 252, 000±64, 000/mm3 in healthy persons. Bleeding time coagulation time and prothrombin time were prolonged in 42.5%, 22.5% and 20% respectively in chronic renal failure. But the above laboratory bleeding tendency was not correlated to the, severity of clinical bleeding manifestation
In chronic renal failure, the maximal level. of aggregation by ADP was markedly decreased to 52.0±25.0% in contrast to 90.5±11.2%. in healthy persons. The maximal degree of aggregation by epinephrine was also markedly decrecased to 54.9±94%
20 in contrast to 87.51-15.4%. There was reverse correlation between the degree of platelet aggregation and the concentration of serum BUN and creatinine.
In chronic renal failure, the degree of platelet adhesiveness was markedly decreased to 26.9±12.3% in contrast to 47.3±9.7% in healthy persons. But the degree of platelet adhesiveness was .not related to the concentration of serum BUN and creatinine.
We noted considerable improvement in platelet function- in 9 patients after hemodialysis and renal transplantation.
|