Platelet Activation During Hemodialysis Measured Through Expression of P-selectin

Kim, Hyung Jik; Koo, Ja Ryong; Chae, Dong Wan; Noh, Jung Woo

Abstract

Recent studies suggested that platelet activation with surface expression of P-selectin may be related to a loss of viability and early clearing from circulation by monocytes and macrophages of the reticuloendothelial system. We have studied platelet activation during hemodialysis with a cuprophane membrane in eighteen patients with uremia. Blood samples were obtained at the begining of the hemodialysis(sample I) and after 1 hr of hemodialysis (sample II), and at the end of hemodialysis from the venous line (sample III). Platelet surface expression of P-selectin(CD62) was determined by flow cytometry. Percentage of positive platelets(% PP) of P- selectin was measured 43.9+/-15.6 % in sample I, 36.9+/-16.0% in sample II, and 40.1+/-13.1% in sample III. No statistical differences in P-selectin expression were observed in sample I, II, and III throughout the period of hemodialysis although platelet P-selectin expression after 1 hour of hemodialysis showed a slightly decrease(P=0.44). However, a significant increase in fluorescence occurred in samples from uremic patients(43.0+/-15.6%) with respect to low fluorescence was seen in normal control sera(14.6+/-11.2%). Our study shows that the substantial and irreversible platelet P-selectin expression might be contributing factors in early clearing of platelet from circulation in uremic patients.