This study shows first, that HD-induced PMN and platelet degranulation are early, most probably calcium-dependent processes and, secondly, that the formation of ox-LDL is clearly dependent on the type of anticoagulant applied.
Our findings clearly show that both types of super-flux dialyzers reduced tHcy significantly. As the molecular weight of free homocysteine is less than 268 D, the most likely explanation seems to be the removal of uremic toxins with inhibitory activities against enzymes involved in the extrarenal homocysteine metabolism.
Screening for pseudothrombocytopenia caused by in vitro platelet clumping has been performed in 45,000 subjects attending a general hospital. In our region, the observed prevalence of EDTA-induced pseudothrombocytopenia in blood samples with an initial platelet count below 150 x 10(9)/l was estimated to amount to 0.1%. EDTA-induced pseudothrombocytopenia was confirmed by detection of platelet aggregates by means of microscopic evaluation from the blood smear. In routine investigations, pseudothrombocytopenia could be highly suspected when the Sysmex NE 8000 showed characteristic peculiarities in the white blood cell (WBC) scattergram and histogram. Platelet aggregation is avoided in such cases by the use of citrate as an anticoagulant instead of EDTA. Pseudothrombocytopenia was detected in 46 subjects. As a screening test for pseudothrombocytopenia, increased cut-off values derived from the WBC histogram demonstrated 90% sensitivity and 100% specificity. Automated flagging for platelet clumps, deviations reflecting MPV, or PDW abnormalities revealed lower scores with respect to sensitivity.
Based on these results, both PS and CTA super-flux dialyzers appear safe for clinical use. Whether changes in CRP values, which are associated with intercurrent clinical events, influence the long-term prognosis of chronic HD patients remains to be established.
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