Platelet Count and Thrombopoietic Activity in Patients with Chronic Renal Failure

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Abstract
The frequency of thrombocytopenia in patients with chronic renal failure (CRF) is controversial. This study was undertaken to investigate the platelet count in 55 patients with end-stage renal disease on maintenance hemodialysis and in 19 patients with CRF before hemodialysis had begun. In both groups platelet counts were similar and significantly reduced, 175,000 ± 6,500 and 181,000 ± 10,800 compared to 253,000 ± 3,700/mm3 in the control (p < 0.0001). 31% of hemodialysis patients had thrombocytopenia (platelet count < 150,000/mm3). The megakaryocyte number in their bone marrow aspirate was not reduced. Primary renal disease, androgen treatment or parathyroidectomy did not affect the platelet count. Thrombopoietic activity using 75Se-selenomethionine incorporation into platelets measured in 7 thrombocytopenic patients was found to be reduced, 6.77 ± 0.29 vs. 9.06 ± 0.27 (× 10_2%; p < 0.001). This study shows that the platelet count is reduced and mild thrombocytopenia is frequent in patients with CRF. A possible cause for the platelet count reduction is insufficient thrombopoietic activity.

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