Effect of parameters of renal replacement therapy on platelet aggregation activity

Цель исследования: оценить влияние параметров заместительной почечной терапии (ЗПТ) на агрегационную активность тромбоцитов у пациентов с хронической болезнью почек (ХБН). Материалы и методы. Было выполнено 25 процедур гемодиализа (ГД) и 10 процедур гемодиафильтрации (ГДФ) 35 больным с ХБП. Изучали динамику агрегационной активности тромбоцитов до и после экстракорпоральных процедур. Результаты. После процедуры ГД агрегация тромбоцитов снижалась, а после процедуры ГДФ нарастала, не выходя за пределы нормальных значений. Параметры процедур ЗПТ на агрегацию тромбоцитов значимого влияния не оказывали. Заключение. Разовая процедура ЗПТ протяженностью не более 4 ч, проводимая с учетом всех современных требований к диализной терапии, не оказывает негативного влияния на функциональную активность тромбоцитов. Процедура ГДФ приводит к непринципиальному росту агрегационной активности тромбоцитов. Aim: to assess the effect of renal replacement therapy (RRT) parameters on platelet aggregation activity in patients with chronic kidney disease (CKD). Materials and methods. For 35 patients with CKD 25 hemodialysis (HD) procedures and 10 hemodiafiltration (HDF) procedures were performed. We studied the dynamics of platelet aggregation activity before and after extracorporeal procedures. Results. After the HD procedure, platelet aggregation decreased, and after the HDF procedure it increased, without going outside the normal range. Parameters of RRT procedures did not have a significant effect on platelet aggregation. Conclusion. A single RRT procedure not more than 4 hours with all nowadays requirements for dialysis therapy does not adversely affect the functional platelets activity. The HDF procedure leads to an unprincipled increasing of platelet aggregation activity.

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NT-proBNP in the Prognosis of Death or Need for Renal Replacement Therapy in Patients with Stage 3–5 Chronic Kidney Disease

Cardiorenal Medicine ◽

10.1159/000496238 ◽

2019 ◽

Vol 9 (2) ◽

pp. 125-134

Author(s):

Leszek Gromadziński ◽

Beata Januszko-Giergielewicz ◽

Kamila Czarnacka ◽

Piotr Pruszczyk

Keyword(s):

Chronic Kidney Disease ◽

Renal Replacement Therapy ◽

Kidney Disease ◽

Replacement Therapy ◽

Independent Predictor ◽

Characteristic Curve ◽

Multivariate Regression Analysis ◽

Dialysis Therapy ◽

Cutoff Value ◽

Initiation Of Dialysis

Background: The risk of cardiovascular (CV) complications is much greater in patients with chronic kidney disease (CKD). The aim of this study was to assess predictors of mortality, renal failure progression, and the need for dialysis in patients with CKD. Methods: The study group consisted of 70 patients with stage 3–5 CKD, followed up on average for 33.4 ± 15.6 months. Laboratory tests and echocardiography were performed on all patients. Composite endpoints were defined as (1) all-cause mortality and (2) mortality or renal replacement therapy (RRT), defined as the initiation of dialysis therapy. Results: During the observation period, 13 patients died and 11 began dialysis therapy. NT-proBNP was found to be a significant predictor in receiver operating characteristic curve analysis for all study endpoints. The optimal cutoff value for NT-proBNP as a predictor of mortality was 569.8 pg/mL, with a sensitivity of 53.8% and a specificity of 89.1%. For mortality or RRT, the cutoff value for NT-proBNP was 384.9 pg/mL, with a sensitivity and specificity of 70.8 and 72.7%, respectively. In a multivariate regression analysis, NT-proBNP was an independent predictor of mortality with an OR = 7.5 (95% CI: 1.05–53.87; p = 0.044) and of mortality or RRT with an OR = 4.7 (95% CI: 1.01–22.66; p = 0.048). Conclusions: NT-proBNP is an independent predictor of mortality in patients with CKD and can also be useful for CV risk stratification in this patient population.

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