Study of red cell deformability and homeostasis in chronic renal failure

ABSTRACT

Fourty subjects included in this study were divided into four groups control healthy, non dialysed uraemia [ND], peritoneal dialysis [PD] and hemodialysis [HD] groups [10 of each]. This study aimed at elucidating the effect of uraemia on RBC deformability, platelet functions and some coagulation factors and the possible effect of dialysis on these parameters. The estimation of RBC deformability, blood viscosity, platelet aggregation, Platelet Factor 3 [PF2] availability, bleeding time, fibrinogen, factor VIII and Antithrombin III [AT III] were done for all subjects. The obtained results revealed that RBC deformability, platelet aggregation and platelet F3 availability were reduced and bleeding time was prolonged in both non dialysed and dialysed groups than control group, though these parameters partially improved by dialysis. Also platelet defects were improved more efficiently by PD than HD. Factor VIII coagulant activity was elevated significantly in both uraemic ND and PD patients with further elevation in HD patients. A significant increase in plasma fibrinogen level was found in ND and PD patients as compared with control, while no significant change was detected in HD patients. AT III was found to be significantly reduced in dialysed or non-dialysed uraemic patients than control, though it is significantly higher in HD than PD patients. We conclude that RBC deformability, platelet functions and bleeding time are impaired in end stage renal failure [ESRF] patients and partially improved with either haemo or peritoneal dialysis, while platelet defects are improved more efficiently by PD. Also, in conclusion plasma fibrinogen [in ND and PD], factor VIII are elevated and AT III level is lowered in ESRF patients, dialysis improved AT III partially to subnormal values with a better correction by HD than PD