Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Pathophysiol Haemost Thromb 2005;34:274–278 DOI: 10.1159/000093107 The Influence of the Haemodialysis Procedure on Platelets, Coagulation and Fibrinolysis Mišo Šabovic ˇ a Barbara Salobir a Irena Preložnik Zupan b Petra Bratina a, c Vida Bojec a, c Jadranka Buturovic ˇ Ponikvar c Departments of a Vascular Diseases, b Haematology, and c Nephrology and Dialysis, University Clinical Centre, Ljubljana, Slovenia activation remained unchanged during the process of haemodialysis. However, in post-haemodialysis sam- ples, t-PA activity was significantly increased. Other fi- brinolytic parameters remained unchanged. In conclu- sion, our results showed that the current technique of haemodialysis procedure does not affect platelet aggre- gation or activate coagulation, and therefore, does not contribute to a thrombotic tendency. However, it does directly affect fibrinolysis through activation of t-PA, which might be clinically relevant since this could in- crease the bleeding tendency in some haemodialysis pa- tients. Copyright © 2005 S. Karger AG, Basel Introduction It is widely believed, mainly based on results from rel- atively old studies, that not only chronic renal disease but also the haemodialysis process by itself activates platelets, coagulation and fibrinolysis [1–11] . The haemodialysis procedure could influence haemostasis by two distinct pathways: first, by the effect of the dialysis membrane, the composition of the dialysis circuit, and changed rhe- ology, and second, by the effect of added anticoagulants Key Words Haemodialysis  Coagulation  Fibrinolysis Abstract In end-stage renal disease, in particularly when treated with haemodialysis, the function of platelets, coagula- tion and fibrinolytic systems can be disturbed, thus con- tributing to either thrombotic or bleeding complications. It is important to know whether the currently used hae- modialysis procedure itself (by biocompatible mem- branes and better anticoagulation with nandroparin) af- fects platelets, coagulation or fibrinolysis. In 15 patients who had been treated with chronic haemodialysis, we measured and compared platelet aggregation (induced by adenosine diphosphate, collagen and epinephrine), the markers of coagulation and fibrinolysis activation (thrombin-antithrombin complexes, thrombin fragments F1+2, D-dimer), and fibrinolytic parameters, i.e. fibrino- gen, plasminogen, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 1 antigen and activ- ity, before and immediately after the regular haemodi- alysis sessions. We did not find differences between pre- and post-haemodialysis platelet aggregation induced with all agents. Markers of coagulation and fibrinolysis Received: August 31, 2005 Accepted after revision: December 14, 2005 Mišo Šabovic ˇ , MD, PhD Department of Vascular Diseases, University Clinical Centre Zaloška 2 SI–1000 Ljubljana (Slovenia) Tel. +386 1 522 80 32, Fax +386 1 522 80 70, E-Mail miso.sabovic@trnovo.kclj.si © 2005 S. Karger AG, Basel 1424–8832/05/0346–0274$22.00/0 Accessible online at: www.karger.com/pht