ABSTRACT
End-stage renal disease patients [ESRD] are at risk of hematological complications. Hypercoagulability and paradoxically hemorrhagic tendency have been described in uremic patients. Hemorrhagic complications are primarily due to uremic platelet dysfunction and intermittent anticoagulation therapy used in hemodialysis. The aim of this study was to investigate the effect of hemodialysis [HDD] on platelet aggregation abnormalities and hence its role in bleeding in ESRD patients on maintenance hemodialysis. Forty two patients with ESRD on maintenance HD, in the hemodialysis unit at Sohag University Hospital utilizing polysulphon memrance and using Fresenius machines 94008 B] were included in this study and compared with a control group; of fourteen healthy adult volunteers. Blood samples were obtained for laboratory investigations form patients and controls before HD session and after the session from patients only the following laboratory investigations were performed; Complete blood cont [CBC]. serum urea, creatinine, Bilirubin, AST, ALT and hepatitis markers [HBsAg and anti HCV antibody]. tests for coagulation screening; PT and PTT, Study of platelet aggregation with ADP and Ristocetin. For all patients and controls bleeding time [BT] was performed at the time of sample taking. Bleeding time is significantly prolonged after the HD session comparing to results before the HD session and that of controls, platelet aggregation with ADDP and Ristocetin were significantly decreased in HD patients before and after session comparing to controls and also statistically significant comparing the results of patients before and after HD session. There is no statistically significant difference in the results of INR and PTT when comparing results of patients before and after sessions and when comparing the results of patients to controls, HD sessions in ESRD patients lead to platelet aggregation abnormalities which may resulted in hemorrhagic disorders in HD dependent patients