Platelet Dysfunction among Patients with End Stage Renal Diseases (Review Article)

Introduction and

Platelet dysfunction is a major determinant of bleeding among patients with end stage renal disease (ESRD). The present article has summarized some of published articles about clinical and laboratory manifestations, pathogenesis and treatment of platelet dysfunction among these patients.

Collecting current data, many studies have reviewed with key words of platelet dysfunction, bleeding and ESRD in a variety of sources such as PubMed, Scopus, and etc. Manuscripts published in English and Persian languages as full-text articles were included in our study.

The causes of platelet impairment among patients with ESRD are multifactorial and include anemia, accumulation of uremic toxins, von willebrand factor dysfunction and increase synthesis of prosthacyclin and nitric oxide which are platelet inhibitor. Although specific therapy is not required in patients without bleeding, however correction of platelet dysfunction is desirable among patients with active bleeding or patients who candidate for kidney or liver biopsy. Treatment options include correction of anemia, dialysis, administration of desmopressin which increase release of VIII factor and von willebrand factor multimers from endothelial cells, cryoprecipitate and conjugated estrogens.

Excessive bleeding may occur among uremic patients in response to injury or invasive and noninvasive procedures and therefore appropriate treatment should be performed among these patients.