The Effect of Erythropoiesis-Stimulating Agents on Platelet Aggregation in Peritoneal Dialysis Patients

Abstract

Introduction:Erythropoietin (Epo) is a hormone that is synthesized in the kidneys and that stimulates the erythropoiesis in the bone marrow. Epo has effects apart from the erythropoiesis. In chronic renal failure (CRF) patients, hemorrhagic diathesis is observed, and Epo production is decreased. Erythropoiesis-stimulating agents (ESAs) are widely used in the treatment of renal anemia in these patients. Our study aimed to investigate the effect of ESAs use on platelet aggregation in peritoneal dialysis (PD) patients due to CRF.Methods:Forty-three PD patients were included in the study. Seventeen patients had been using ESAs for anemia for at least three months (ESAs user group). Twenty-six patients were not using ESAs since they did not have indications (non-ESAs user group). Platelet aggregation measurement from the whole blood was carried out in each patient by a multiplate device. The calculated values [area under the curve (AUC), aggregation, and velocity] were recorded. The results were evaluated statistically, and p<0.05 was accepted as statistically significant.Results:In the non-ESAs user group, the mean hemoglobin level was found higher when compared to the other group, and this difference was statistically significant (p<0.001). The percentage of transferrin saturation was found higher in the ESAs user group (p=0.021). It was observed that AUC, aggregation, and velocity values were lower in the ESAs user group, and the result was not statistically significant (p values were 0.202, 0.329, 0.290, respectively).Conclusion:ESAs use in PD patients did not have any effect on platelet aggregation. Further prospective studies involving platelet aggregation tests before and after ESA treatment in dialysis patients are needed.

Keywords

• platelet aggregation
• erythropoiesis-stimulating agents
• peritoneal dialysis