Platelet Destruction in Renal Disease

A Complement-Dependent Model of Thrombotic Thrombocytopenic Purpura Induced by Antibodies Reactive with Endothelial Cells

“…To this end, anti-endothelial cell antibodies have been suggested as etiologic in TTP, although their presence remains controversial (41,47). Another example of primary endothelial cell injury which can lead to renal damage is that occurring with anti-phospholipid antibodies; while in this disease activation of the clotting cascade is typical, a TTP-like picture can also result (48).…”

“…However, the control animals preimmunized with mouse IgG and given normal mouse IgG also had lowered platelet counts. Presumably, this reflects the development of acute serum sickness, with its effects on platelets (40,41). Interestingly, animals preimmunized with normal mouse IgG had deposition of mouse and rat IgG in the glomerular mesangium, likely reflecting deposition of circulating immune complexes of mouse and rat IgG (Fig.…”

Hemodialysis effect on platelet count and function and hemodialysis-associated thrombocytopenia

“…Physical destruction of platelets may occur because of intravascular catheters. 67 Thrombocytopenia and platelet dysfunction are commonly seen in liver disease, paraproteinemia, myeloproliferative disorders, and myelodysplastic syndrome. 66,67 Thrombocytopenia may be found in patients receiving nicotinamide for treatment of cholesterol abnormalities or hyperphosphatemia, 68 and many drugs sometimes taken by hemodialysis patients, including clopidogrel and other antiplatelet agents, as well as quinine, for example, can cause drug-induced thrombocytopenia.…”

“…67 Thrombocytopenia and platelet dysfunction are commonly seen in liver disease, paraproteinemia, myeloproliferative disorders, and myelodysplastic syndrome. 66,67 Thrombocytopenia may be found in patients receiving nicotinamide for treatment of cholesterol abnormalities or hyperphosphatemia, 68 and many drugs sometimes taken by hemodialysis patients, including clopidogrel and other antiplatelet agents, as well as quinine, for example, can cause drug-induced thrombocytopenia. 69 Finally, in actively bleeding patients, dilutional thrombocytopenia can occur when transfusing packed red blood cells (RBCs) only, as functional platelets are not present in packed RBC transfusions.…”

Platelet X-Ray Microanalysis in Patients with Chronic Renal Failure

“…In creased capillary fragility and thrombocytopenia [1] as well as increased platelet destruction [2] have been described in certain renal disorders. In addition, de creased prothrombin consumption, diminished plate let factor 3 availability, abnormal platelet adhesive ness and aggregation, low serotonin content and poor clot retraction found in patients with CRF [3] served as an additional explanation for the hemostatic de fects.…”