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Platelets of patients with chronic kidney disease demonstrate deficient platelet reactivity in vitro.

van Bladel ER, de Jager RL, Walter D, Cornelissen L, Gaillard CA, Boven LA, Roest M, Fijnheer R - BMC Nephrol (2012)

Bottom Line: Area under the curve and the concentration of half-maximal response were determined.Also the area under the curve was significantly different.There was no significant difference in half-maximal response between both groups.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands.

ABSTRACT

Background: In patients with chronic kidney disease studies focusing on platelet function and properties often are non-conclusive whereas only few studies use functional platelet tests. In this study we evaluated a recently developed functional flow cytometry based assay for the analysis of platelet function in chronic kidney disease.

Methods: Platelet reactivity was measured using flow cytometric analysis. Platelets in whole blood were triggered with different concentrations of agonists (TRAP, ADP, CRP). Platelet activation was quantified with staining for P-selectin, measuring the mean fluorescence intensity. Area under the curve and the concentration of half-maximal response were determined.

Results: We studied 23 patients with chronic kidney disease (9 patients with cardiorenal failure and 14 patients with end stage renal disease) and 19 healthy controls. Expression of P-selectin on the platelet surface measured as mean fluorescence intensity was significantly less in chronic kidney disease patients compared to controls after maximal stimulation with TRAP (9.7 (7.9-10.8) vs. 11.4 (9.2-12.2), P=0.032), ADP (1.6 (1.2-2.1) vs. 2.6 (1.9-3.5), P=0.002) and CRP (9.2 (8.5-10.8) vs. 11.5 (9.5-12.9), P=0.004). Also the area under the curve was significantly different. There was no significant difference in half-maximal response between both groups.

Conclusion: In this study we found that patients with chronic kidney disease show reduced platelet reactivity in response of ADP, TRAP and CRP compared to controls. These results contribute to our understanding of the aberrant platelet function observed in patients with chronic kidney disease and emphasize the significance of using functional whole blood platelet activation assays.

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Platelet reactivity. A: The mean fluorescence intensity (MFI) of all platelets, expressed in arbitrary units (AU) and B: area under the curve (AUC), displayed as median plus interquartile range, for chronic kidney disease patients (CKD) and controls.
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Figure 1: Platelet reactivity. A: The mean fluorescence intensity (MFI) of all platelets, expressed in arbitrary units (AU) and B: area under the curve (AUC), displayed as median plus interquartile range, for chronic kidney disease patients (CKD) and controls.

Mentions: Expression of P-selectin on the platelet surface measured as MFI was significantly lower in chronic kidney disease patients compared to controls after maximal stimulation with TRAP (9.7 (7.9-10.8) vs. 11.4 (9.2-12.2), P = 0.032), ADP (1.6 (1.2-2.1) vs. 2.6 (1.9-3.5), P = 0.002) and CRP (9.2 (8.5-10.8) vs. 11.5 (9.5-12.9), P = 0.004). (Figure1 and Table2). Maximal P-selectin expression in response to different agonist correlated significantly with each other (Spearmann’s Rho correlation TRAP and ADP 0.684 with p < 0.001; TRAP and CRP 0.538 with p < 0.001; ADP and CRP 0.475 with p = 0.001). Table2 shows that the EC50 was not different between chronic kidney disease patients and controls.


Platelets of patients with chronic kidney disease demonstrate deficient platelet reactivity in vitro.

van Bladel ER, de Jager RL, Walter D, Cornelissen L, Gaillard CA, Boven LA, Roest M, Fijnheer R - BMC Nephrol (2012)

Platelet reactivity. A: The mean fluorescence intensity (MFI) of all platelets, expressed in arbitrary units (AU) and B: area under the curve (AUC), displayed as median plus interquartile range, for chronic kidney disease patients (CKD) and controls.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3473261&req=5

Figure 1: Platelet reactivity. A: The mean fluorescence intensity (MFI) of all platelets, expressed in arbitrary units (AU) and B: area under the curve (AUC), displayed as median plus interquartile range, for chronic kidney disease patients (CKD) and controls.
Mentions: Expression of P-selectin on the platelet surface measured as MFI was significantly lower in chronic kidney disease patients compared to controls after maximal stimulation with TRAP (9.7 (7.9-10.8) vs. 11.4 (9.2-12.2), P = 0.032), ADP (1.6 (1.2-2.1) vs. 2.6 (1.9-3.5), P = 0.002) and CRP (9.2 (8.5-10.8) vs. 11.5 (9.5-12.9), P = 0.004). (Figure1 and Table2). Maximal P-selectin expression in response to different agonist correlated significantly with each other (Spearmann’s Rho correlation TRAP and ADP 0.684 with p < 0.001; TRAP and CRP 0.538 with p < 0.001; ADP and CRP 0.475 with p = 0.001). Table2 shows that the EC50 was not different between chronic kidney disease patients and controls.

Bottom Line: Area under the curve and the concentration of half-maximal response were determined.Also the area under the curve was significantly different.There was no significant difference in half-maximal response between both groups.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands.

ABSTRACT

Background: In patients with chronic kidney disease studies focusing on platelet function and properties often are non-conclusive whereas only few studies use functional platelet tests. In this study we evaluated a recently developed functional flow cytometry based assay for the analysis of platelet function in chronic kidney disease.

Methods: Platelet reactivity was measured using flow cytometric analysis. Platelets in whole blood were triggered with different concentrations of agonists (TRAP, ADP, CRP). Platelet activation was quantified with staining for P-selectin, measuring the mean fluorescence intensity. Area under the curve and the concentration of half-maximal response were determined.

Results: We studied 23 patients with chronic kidney disease (9 patients with cardiorenal failure and 14 patients with end stage renal disease) and 19 healthy controls. Expression of P-selectin on the platelet surface measured as mean fluorescence intensity was significantly less in chronic kidney disease patients compared to controls after maximal stimulation with TRAP (9.7 (7.9-10.8) vs. 11.4 (9.2-12.2), P=0.032), ADP (1.6 (1.2-2.1) vs. 2.6 (1.9-3.5), P=0.002) and CRP (9.2 (8.5-10.8) vs. 11.5 (9.5-12.9), P=0.004). Also the area under the curve was significantly different. There was no significant difference in half-maximal response between both groups.

Conclusion: In this study we found that patients with chronic kidney disease show reduced platelet reactivity in response of ADP, TRAP and CRP compared to controls. These results contribute to our understanding of the aberrant platelet function observed in patients with chronic kidney disease and emphasize the significance of using functional whole blood platelet activation assays.

Show MeSH
Related in: MedlinePlus