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. 2020 Dec;40(5):671-678.
doi: 10.1055/a-1171-0499. Epub 2020 Jul 27.

In Vitro Closure Times (PFA-100) Are Different Between Peritoneal Dialysis and Hemodialysis

Cenk Gokalp  1 , Fatma Keklik Karadag  2 , Matthias Christoph Braunisch  3 , Christoph Schmaderer  3 , Emrah Gunay  1 , Hatice Demet Kiper  4 , Mahmut Tobu  4 , Celalettin Ustün  5 , Meltem Sezis Demirci  1 , Mehmet Ozkahya  1
Affiliations

In Vitro Closure Times (PFA-100) Are Different Between Peritoneal Dialysis and Hemodialysis

Cenk Gokalp et al. Hamostaseologie. 2020 Dec.

Abstract
in English, German

Introduction: Platelet dysfunction is not uncommon in patients with end-stage renal disease (ESRD). Type of renal replacement therapy may have an effect on platelet functions, which has not been well investigated. We evaluated in vitro closure time (CT) differences between peritoneal dialysis (PD) and hemodialysis (HD) patients using platelet function analyzer (PFA-100)and observed a significant difference between these renal replacement therapies.

Methods: Patients with ESRD undergoing PD (n = 24) or HD (n = 23) for more than 6 months were included. Blood samples for collagen/epinephrine (Col/EPI) and collagen/adenosine diphosphate (Col/ADP) measurements were obtained before HD at a mid-week session for HD patients and at an outpatient control time for PD patients.

Results: Three of 24 (12.5%) PD patients and 16 of 23 (69.5%) HD patients had prolonged PFA-100 Col/EPI, p< 0.001. Likewise, 4.2% of PD patients and 87.0% of HD patients had prolonged PFA-100 Col/ADP, p< 0.001. Moreover, the median times of PFA-Col/EPI and PFA-100 Col/ADP were significantly lower in PD patients compared with those of HD patients (p< 0.001). Multivariate analysis showed that the type of renal replacement was a risk factor for both elevated PFA-100 Col/ADP and PFA-100 Col/EPI after adjusted for platelets, hematocrit, and urea (p< 0.001).

Conclusions: The type of renal replacement therapy may have an effect on in vitro CTs; therefore, studies including more patients with long-term follow-up are needed to investigate if the difference has any impact on clinical outcomes.

Eine Thrombozytendysfunktion ist bei Dialysepatienten nicht selten. Unklar ist inwieweit das Dialyseverfahren einen Einfluss auf die Thrombozytenfunktion hat. Wir untersuchten die in vitro Verschlusszeit mittels PFA-100 bei n = 24 Patienten mit Peritonealdialyse (PD) und n = 23 Patienten mit Hämodialyse (HD). Blutproben zu Messung von Kollagen/Adrenalin (Col/EPI) und Kollagen/ADP (Col/ADP) wurden bei HD-Patienten vor einer in der Mitte der Woche stattfindenden Dialysesitzung und bei PD-Patienten zur ambulanten Visite abgenommen. 13% der PD- und 70% der HD-Patienten hatten eine verlängerte PFA-100 Col/EPI. Ebenso lag bei 4% der PD- und 87% der HD-Patienten eine verlängerte PFA-100 Col/ADP vor. Gleichermaßen waren die medianen Verschlusszeiten von PFA-100 Col/EPI und Col/ADP bei PD- im Vergleich zu HD-Patienten signifikant niedriger. Nach Adjustierung blieb das Dialyseverfahren ein Risikofaktor sowohl für eine erhöhte PFA-100 Col/EPI als auch für eine PFA-100 Col/ADP. Weitere Studien sind notwendig um zu evaluieren, ob dieser Unterschied einen langfristigen Einfluss auf das klinische Outcome hat.

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Conflict of interest statement

The authors declare that they have no conflict of interest.