PLASMA β-THROMBOGLOBULIN IN PATIENTS UNDERGOING HEMODIALYSIS

Abstract

Abnormal platelet function of patients with chronic renal failure (CRF) has been documented.
We have measured β-thromboglobulin (β-T. G.), a platelet specific protein in 33 patients with CRF undergoing hemodialysis using a β-T. G. RIA kit, and have investigated whether the β-T. G, can be an indicator of the clinical condition of these patients.
The patients were 23 males and 10 females, with the mean age of 42.7 years (range 23 to 73 years).
The mean term of hemodialysis was 23.8 months (range 2 to 65 months) and the mean serum creatinine (S-crea) was 13.14mg/dl (range 5.7 to 18.8mg/dl). The mean plasma β-T. G. value of the patients was 122.52±50.12ng/ml (range 56.3 to 250ng/ml, n=49), and was significantly higher than that of 11 normal control subjects which was 29.03±14.98ng/ml (range 7.3 to 62.1ng/ml, n=24) (p<0.001). The mean platelet-count of the patient was 188, 900± 51, 600 (range 86, 000 to 268, 000, n=32), which was lower than that of control subjects with platelet count of 252, 000±43, 200 (range 154, 000 to 306, 000, n=13). The 3-T. G, value of the patients showed a correlating tendency with the S-crea, value, but it was not significant. The β-T. G, value did not correlate with the urine volume, platelet count, red blood cell count, white blood cell count, hemoglobin value, hematocrit, sodium, potassium and calcium in the blood.
The β-T. G, value was significantly correlated with the term of hemodialysis (p<0.01). The result is considered due to the long-term effects of uremic toxins, thrombus formations, platelet damage by dialyzer and anticoagulants during hemodialysis.
The β-T. G, value was significantly correlated with the average water reductive volume by hemodialysis per ideal body weight during 3 months before the experiment (p<0.05).
The β-T. G. was also investigated immediately before and after hemodialysis in 10 patients and it increased after hemodialysis except in a patient which had no water reduction. β-T. G, values increased proportionally after hemodialysis in patients with increased water reduction.
Because the hemodialysis accompanies a hypovolemic shock of greater or lesser degree, the disturbance of the microcirculation or of the interaction between platelets and blood vessel wall in whole body, especially in the blood stagnated organs, could not be ignored. Incidentally, the spleen, ileum, kidney and the liver were organs which contained large amounts of β-T. G.. Therefore, we emphasize water restriction to patients with CRF undergoing hemodialysis.
The B-T. G, value of 5 patients complicated with other disorders was higher, and the β-T. G. value was significantly correlated with the clinical criterion (p<0.02). Plasma β-T. G. measurement could be an indicator of the condition of the patient with CRF undergoing hemodialysis.