What is the role of platelet dysfunction in uremia?

Updated: Nov 30, 2019
  • Author: Perumal Thiagarajan, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Abnormal bleeding is common in patients with uremia. Bleeding time is generally very prolonged. The bleeding has the characteristics of a platelet disorder, and GI tract bleeding is the most frequent manifestation.

Platelet function in uremic patients improves after dialysis. A number of dialyzable factors have been shown to inhibit platelet function. Furthermore, uremic platelets synthesize less thromboxane A2, and the blood vessels in patients with uremia produce greater quantities of platelet-inhibitory prostaglandin.

Nitric oxide produced by the endothelial cells inhibits platelet function. Because the prolonged bleeding time and the hemostatic abnormalities are partly corrected by red blood cell transfusion or erythropoietin therapy, the failure of hemoglobin to quench excess nitric oxide synthesis has been suggested as partly responsible for the platelet dysfunction.

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