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Increased platelet-monocyte aggregates and cardiovascular disease in end-stage renal failure patients.
Nephrol Dial Transplant 2003; 18(10):2088-96ND

Abstract

BACKGROUND

Atherosclerotic cardiovascular disease is a major cause of morbidity and mortality in patients with end-stage renal disease. This excess morbidity cannot be entirely explained by well-recognized conventional and novel risk factors alone, and occurs irrespective of dialysis modality. Recent evidence suggests that the activation of platelets and their interaction with circulating cells are important independent risk factors for atherosclerosis in non-uraemic patients. We therefore studied platelet activation and circulating platelet-leucocyte aggregates in stable patients without evidence of cardiovascular disease on continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis and investigated an association with cardiovascular events.

METHODS

Immunofluorescent flow cytometry was used to measure the percentage of P-selectin- (CD62P) positive platelets, the percentage of platelet-neutrophil and platelet-monocyte aggregates, and the expression of the P-selectin ligand, P-selectin glycoprotein ligand-1 (PSGL-1, CD162) on leucocytes in haemodialysis and CAPD patients and normal controls. The platelet count and the mean platelet component (MPC, a measure of platelet activation) were determined on the ADVIATM 120 Haematology System (Bayer, NY).

RESULTS

Platelet activation as assessed by MPC or CD62P expression was significantly increased in haemodialysis but not CAPD patients compared with controls. Circulating platelet-monocyte aggregates were significantly increased in parallel with a significant reduction in PSGL-1 expression on monocytes in both patient groups compared with normal controls. The presence of higher platelet-monocyte aggregates in dialysis patients was associated with increased cardiovascular events.

CONCLUSION

We describe increased platelet-monocyte aggregates with reduced leucocyte PSGL-1 expression in patients with end-stage renal disease irrespective of dialysis modality, associated with an increased risk of cardiovascular disease. These findings may suggest a novel mechanism by which accelerated atherosclerosis occurs in uraemic patients.

Authors+Show Affiliations

Department of Renal Medicine and Transplantation, The Royal London Hospital, Whitechapel, London E1 1BB, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

13679485

Citation

Ashman, Neil, et al. "Increased Platelet-monocyte Aggregates and Cardiovascular Disease in End-stage Renal Failure Patients." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 18, no. 10, 2003, pp. 2088-96.
Ashman N, Macey MG, Fan SL, et al. Increased platelet-monocyte aggregates and cardiovascular disease in end-stage renal failure patients. Nephrol Dial Transplant. 2003;18(10):2088-96.
Ashman, N., Macey, M. G., Fan, S. L., Azam, U., & Yaqoob, M. M. (2003). Increased platelet-monocyte aggregates and cardiovascular disease in end-stage renal failure patients. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 18(10), pp. 2088-96.
Ashman N, et al. Increased Platelet-monocyte Aggregates and Cardiovascular Disease in End-stage Renal Failure Patients. Nephrol Dial Transplant. 2003;18(10):2088-96. PubMed PMID: 13679485.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased platelet-monocyte aggregates and cardiovascular disease in end-stage renal failure patients. AU - Ashman,Neil, AU - Macey,Marion G, AU - Fan,Stanley L, AU - Azam,Urooj, AU - Yaqoob,Muhammad M, PY - 2003/9/19/pubmed PY - 2004/2/10/medline PY - 2003/9/19/entrez SP - 2088 EP - 96 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 18 IS - 10 N2 - BACKGROUND: Atherosclerotic cardiovascular disease is a major cause of morbidity and mortality in patients with end-stage renal disease. This excess morbidity cannot be entirely explained by well-recognized conventional and novel risk factors alone, and occurs irrespective of dialysis modality. Recent evidence suggests that the activation of platelets and their interaction with circulating cells are important independent risk factors for atherosclerosis in non-uraemic patients. We therefore studied platelet activation and circulating platelet-leucocyte aggregates in stable patients without evidence of cardiovascular disease on continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis and investigated an association with cardiovascular events. METHODS: Immunofluorescent flow cytometry was used to measure the percentage of P-selectin- (CD62P) positive platelets, the percentage of platelet-neutrophil and platelet-monocyte aggregates, and the expression of the P-selectin ligand, P-selectin glycoprotein ligand-1 (PSGL-1, CD162) on leucocytes in haemodialysis and CAPD patients and normal controls. The platelet count and the mean platelet component (MPC, a measure of platelet activation) were determined on the ADVIATM 120 Haematology System (Bayer, NY). RESULTS: Platelet activation as assessed by MPC or CD62P expression was significantly increased in haemodialysis but not CAPD patients compared with controls. Circulating platelet-monocyte aggregates were significantly increased in parallel with a significant reduction in PSGL-1 expression on monocytes in both patient groups compared with normal controls. The presence of higher platelet-monocyte aggregates in dialysis patients was associated with increased cardiovascular events. CONCLUSION: We describe increased platelet-monocyte aggregates with reduced leucocyte PSGL-1 expression in patients with end-stage renal disease irrespective of dialysis modality, associated with an increased risk of cardiovascular disease. These findings may suggest a novel mechanism by which accelerated atherosclerosis occurs in uraemic patients. SN - 0931-0509 UR - https://www.unboundmedicine.com/medline/citation/13679485/Increased_platelet_monocyte_aggregates_and_cardiovascular_disease_in_end_stage_renal_failure_patients_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfg348 DB - PRIME DP - Unbound Medicine ER -