Impaired Secondary Platelet Response in Chronic Kidney Disease as a Consequence of Prior Platelet Activation.

Patients with chronic kidney disease (CKD) are at increased risk of thrombotic and hemorrhagic complications. Findings on platelet defects in CKD are conflicting. Therefore, we examined platelet function in CKD stage 3 to 5 dialysis patients without antithrombotic therapy, in CKD5D/hemodialysis patients on acetylsalicylic acid (ASA) as well as in a CKD mouse model. Patients with advanced CKD without antithrombotic therapy show platelet preactivation with a partial secondary platelet dysfunction mainly upon collagen/GPVI stimulation. Platelets from hemodialysis patients on ASA showed a less severe CKD-associated secondary platelet dysfunction compared with those not taking ASA, with comparable observations in CKD mice on ASA vs vehicle.