Lipid Composition of Platelets in Patients with Uremia

Abstract

Aims: The lipid composition of platelets and the function of these cells in patients with uremia were studied. Methods: Fourteen patients and 14 normal volunteers were studied. Platelet lipids including phospholipids and cholesterol, as well as the platelet aggregation response to agonists, were studied. Results: The amount of platelet phospholipids was decreased in patients compared to controls (338.0 ± 79 vs. 511.6 ± 125 nmol/10⁹ cells; p < 0.001), while the percentage of the five main specimens of these compounds was normal. The content of platelet cholesterol in patients (97.8 ± 17.0 µg/10⁹ cells) was similar to that in controls (91.7 ± 26.0 µg/10⁹ cells). Consequently, the cholesterol:phospholipid ratio in uremic platelets was increased (0.75 ± 0.1 vs. 0.46 ± 0.1; p < 0.01). Although this feature is associated with hyperreactive platelets, the aggregation tests were defective for adenosin diphosphate (p < 0.01), arachidonic acid (p < 0.01), epinephrine (p < 0.01) and collagen (p < 0.001). This behavior is probably due to the multifactorial platelet defect described in uremia.

Determination of serum aluminum, platelet aggregation and lipid peroxidation in hemodialyzed patients

“…Although this metal does not display redox capacity, it is capable of inducing peroxidation in cerebral tissue (8) and platelet aggregation in vitro (13). In addition, a high level of this metal is also associated with pathologies such as Alzheimers encephalopathy, amyotrophic lateral sclerosis and ageing (28,29). Vecino et al (29) reported an increase in the cholesterol/phospholipid ratio in the platelets of uremic patients, which was correlated with a hyperreactive state, even though a platelet hypofunction was detected in vitro.…”

Alteration of the platelet transcriptome in chronic kidney disease

“…We also identified genes involved in lipid metabolism, such as glycine N-acyltransferase-like 2 (GLYATL2), phospholipase C eta 1 (PLCH1), phosphatidylcholine transfer protein (PCTP), OSBP2 and SERINC1, whose levels are deregulated in uremic conditions. This may partially explain the altered synthesis of bioactive lipids (40,41) and membrane lipid composition (42,43) observed in platelets of uremic patients.…”

Heparin-Induced Thrombocytopenia Complicating Hemodialysis

“…It was recently reported that the incidence of HIT antibodies in patients receiving chronic hemodialysis is less than in patients receiving dialysis in the acute setting. 18,19 As HIT is frequently associated with potentially life-threatening thrombotic events, discontinuation of heparin treatment and initiation of alternative anticoagulation is considered mandatory. Heparin must not be added to any flushing solution, and heparin-coated systems should not be used.…”