Defective platelet aggregation in response to platelet-activating factor in uremia associated with low platelet thromboxane A2 generation

D. Macconi, G. Vigano, G. Bisogno, M. Galbusera, S. Orisio, G. Remuzzi, M. Livio

Research output: Contribution to journalArticle

Abstract

The bleeding tendency associated with uremia is likely due to a qualitative platelet dysfunction. So far the data available on platelet aggregation are conflicting. Since platelet-activating factor (PAF) plays a role in primary hemostasis, we studied platelet aggregation in response to PAF in 40 patients with chronic uremia on regular hemodialysis and 12 control subjects. Our results showed that in 28 of 40 uremics, platelet aggregation response to PAF was normal, whereas in the remaining 12 it was defective in that no second wave of aggregation was elicited even if the PAF concentrations were increased by a factor of 10,000. This abnormal response was peculiar to PAF and only partially related to factor(s) of plasma origin. The number of platelet PAF receptors and their affinity for the agonist were comparable in controls and 'PAF-unresponsive' patients. The defective platelet aggregation in response to PAF was associated with a statistically significant reduction (P <0.01) in thromboxane A2 (TxA2) generation in platelet-rich plasma (PRP) challenged with PAF (10 and 100 nmol/L). When PRPs from PAF-unresponsive patients were preincubated with a stable analogue of prostaglandin endoperoxides/TxA2 U-46619, an irreversible platelet aggregation in response to PAF was obtained. Thus in a subpopulation of uremics, platelet aggregation in response to PAF is selectively abnormal as a consequence of a reduced TxA2 generation.

Original languageEnglish
Pages (from-to)318-325
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume19
Issue number4
Publication statusPublished - 1992

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Thromboxane A2
Uremia
Platelet Activating Factor
Platelet Aggregation
Blood Platelets
Synthetic Prostaglandin Endoperoxides
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid
Platelet-Rich Plasma
Hemostasis
Platelet Count
Renal Dialysis
Hemorrhage

ASJC Scopus subject areas

  • Nephrology

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Defective platelet aggregation in response to platelet-activating factor in uremia associated with low platelet thromboxane A2 generation. / Macconi, D.; Vigano, G.; Bisogno, G.; Galbusera, M.; Orisio, S.; Remuzzi, G.; Livio, M.

In: American Journal of Kidney Diseases, Vol. 19, No. 4, 1992, p. 318-325.

Research output: Contribution to journalArticle

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AU - Macconi, D.

AU - Vigano, G.

AU - Bisogno, G.

AU - Galbusera, M.

AU - Orisio, S.

AU - Remuzzi, G.

AU - Livio, M.

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