Serkan BAKIRDÖĞEN, Necmi EREN, Mustafa Baki ÇEKMEN, Sibel GÖKÇAY BEK, Sara YAVUZ, Ümit BİLGİLİ, Mehmet TUNCAY, Ant UZAY, Ahmet YILMAZ

Periton Diyaliz Hastalarında Trombosit Agregasyonu Üzerinde Periferik Trombosit ve Lökosit Sayılarının Etkileri

GİRİŞ ve AMAÇ: Bugüne kadar yapılan çalışmalar, sağlıklı kişiler ve koroner arter hastalığı olan hastaların kanındaki trombosit ve lökosit sayısının trombosit agregasyonunu etkilediğini ortaya koymuştur. Çalışmamızın amacı, periton diyalizi uygulayan son dönem böbrek yetmezliği hastalarında trombosit agregasyonu ile lökosit ve trombosit sayısı arasında bir ilişki bulunup bulunmadığını araştırmaktı. YÖNTEM ve GEREÇLER: Kırk üç periton diyalizi hastası çalışmaya dahil edildi. Tam kandan trombosit agregasyonu ölçümü yapabilen multiple elektrot agregometri yöntemi kullanıldı. BULGULAR: Trombosit agregasyonu ile tam kan sayımındaki trombosit ve lökosit sayısı arasında istatistiksel anlamlı pozitif yönde korelasyon saptandı. Bu pozitif korelasyon trombositlerde, lökositlerden daha güçlüydü. TARTIŞMA ve SONUÇ: Periton diyaliz hastalarında trombosit agregasyonu üzerinde tam kan sayımındaki trombosit ve lökosit sayısının önemi olabilir. Bu durum, hastaların artmış tromboz riskine katkı yapan ilave bir faktör olabilir.

The Effects of Peripheral Platelet and Leukocyte Counts on Platelet Agregation in Peritoneal Dialysis Patients

INTRODUCTION: Studies in healthy individuals andpatients with coronary artery disease have demonstratedthat circulating platelet and leukocyte counts affect plateletaggregation. The aim of our study was to investigatewhether there is such a relationship betweenleukocyte/platelet counts and platelet aggregation in endstagerenal disease patients on peritoneal dialysis (PD).METHODS: Forty-three PD patients were included in thestudy. Multiple electrode aggregometry method capable ofmeasuring platelet aggregation in whole blood was used.RESULTS: A statistically significant positive correlationbetween platelet aggregation and leukocyte and platelet countsin complete blood count (CBC) was seen. This positivecorrelation was stronger for platelets than leukocytes.DISCUSSION and CONCLUSION: Platelet and leukocytecounts in CBC in PD patients might be important on plateletaggregation. This might be another risk factor contributing toalready increased thrombosis risk in these patients.

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1. Foley RN, Parfrey PS. Cardiovascular disease and mortality in ESRD. Journal of Nephrology 1998;11(5): 239-45.
2. Glorieux G, Cohen G, Jankowski J, Vanholder R. Progress In Uremic Toxin Research: Platelet/Leucocyte activation, inflamation, and uremia. Seminars in Dialysis 2009;22(4): 423-7.
3. Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest 2005;115: 3378-84.
4. Würtz M, Hvas AM, Kristensen SD, Grove EL. Platelet aggregation is dependent on platelet count in patients with coronary artery disease. Thrombosis Research 2012;129: 56-61.
5. Bochsen L, Johansson PI, Kristensen AT, Daugaard G, Ostrowski SR. The influence of platelets, plasma and red blood cells on functional haemostatic assays. Blood Coagul Fibrinolysis 2011;22: 167-75.
6. Rubak P, Villadsen K, Hvas AM. Reference intervals for platelet aggregation assessed by multiple electrode platelet aggregometry. Thrombosis Research 2012;130: 420-3.
7. Würtz M, Hvas AM, Christensen KH, Rubak P, Kristensen SD, Grove EL. Rapid evaluation of platelet function using the Multiplate Analyzer. Platelets 2014;25(8): 628-33.
8. Stissing T, Dridi NP, Ostrowski SR, Bochsen L, Johansson PI. The influence of low platelet count on whole blood aggregometry assessed by Multiplate. Clinical and Applied Thrombosis/Hemostasis 2011;17(6): 211-7.
9. Müller MR, Salat A, Pulaki S, Stangl P, Ergun E, Schreiner W, et al. Influence of hematocrit and platelet count on impedance and reactivity of whole blood for electrical aggregometry. Journal of Pharmacological and Toxicological Methods 1995;34: 17-22.
10. Di Minno G, Martinez J, McKean ML, De La Rosa J, Burke JF, Murphy S. Platelet dysfunction in uremia. Multifaceted defect partially corrected by dialysis. Am J Med. 1985;79(5): 552-9.
11. Ashman N, Macey MG, Fan SL, Azam U, Yagoob MM. Increased platelet-monocyte aggregates and cardiovascular disease in endstage renal failure patients. Nephrol Dial Transplant 2003;18: 2088-96.
12. Furman MI, Benoit SE, Barnard MR, Valeri CR, Borbone ML, Becker RC, et al. Increased platelet reactivity and circulating monocyte-platelet aggregates in patients with coronary artery disease. J Am Coll Cardiol 1998;31(2): 352-8.
13. Kilickesmez KO, Kocas C, Okcun B, Abaci O, Kaya A, Arat A, et al. Laboratory signs of aspirin response in haemodialysis patients. Scandinavian Journal of Clinical and Laboratory Investigation 2011;71: 426-31.
14. Dubyak GR, el-Moatassim C. Signal transduction via P2-purinergic receptors for extracellular ATP and other nucleotides. Am J Physiol. 1993;265: C577-C606.
15. Stafford NP, Pink AE, White AE, Glenn JR, Heptinstall S. Mechanisms involved in adenosine triphosphate-induced platelet aggregation in whole blood. Arterioscler Thromb Vasc Biol. 2003;23: 1928-33.
16. Renesto P, Chignard M. Enhancement of cathepsin G-induced platelet activation by leukocyte elastase: Consequences for the neutrophil-mediated platelet activation. Blood 1993;82(1): 139-44.
17. Schattner MA, Geffner JR, Isturiz MA, Lazzari MA. Inhibition of human platelet activation by polymorphonuclear leukocytes. Br J Pharmacol. 1990;101(2): 253-6.
18. Valles J, Santos MT, Marcus AJ, Safier LB, Broekman MJ, Islam N, et al. Downregulation of human platelet reactivity by neutrophils. Clin Invest. 1993;92: 1357-65.