Abstract
BackgroundBleeding tendencies can occur with uremia.ObjectivesTo characterize primary hemostatic function in dogs with acute kidney injury (AKI).AnimalsTen dogs with International Renal Interest Society AKI grade III or above and 10 healthy controls.MethodsProspective study comparing PCV, platelet count, platelet aggregometry (Multiplate), and von Willebrand factor antigen to collagen binding activity ratio (vWF:Ag:vWF:CBA) in 2 groups of dogs (AKI group versus controls). Buccal mucosal bleeding time was measured in the AKI group only. Data are presented as median [25th, 75th percentile] unless otherwise stated. Significance was set at P < .05.ResultsMean PCV was significantly lower in the AKI (34.7%; ±SD, 8.8) than in the control (46.1%; ±SD, 3.6; P < .001) group. Platelet count was significantly higher in the AKI (350.5 × 103/μL [301, 516]) than in the control (241 × 103/μL [227, 251]; P = .01) group. Collagen‐activated platelet aggregometry measured as area under the curve was significantly lower in the AKI (36.9 ± 17.7) than in the control (54.9 ± 11.2; P = .05) group. vWF:Ag:vWF:CBA was significantly higher in the AKI (2.2 [1.9, 2.6]) than in the control (1.1 [1.1, 1.2]; P = .01) group. There was a strong correlation between vWF:Ag:vWF:CBA and creatinine (r = 0.859; P < .001), but no other variables.Conclusions and Clinical ImportanceDogs with AKI had decreased collagen‐activated platelet aggregation and appear to have a type II von Willebrand disease‐like phenotype as indicated by the high vWF:Ag:vWF:CBA.
Highlights
This study assessing primary hemostatic function in dogs with acute kidney injury (AKI) found that COL, but not arachidonic acid (AA)- or adenosine diphosphate (ADP), induced platelet aggregation as measured by multiple electrode impedance platelet aggregometry (MEPA) was significantly decreased in dogs with AKI compared to a control population of healthy dogs; aggregation remained within reference intervals
There was no difference in von Willebrand Factor (vWF):von Willebrand factor antigen (Ag) concentration, vWF:Ag:vWF:CBA was significantly higher in dogs with AKI, indicating that less vWF was bound to COL possibly due to a reduction in higher molecular weight (MW) vWF multimers in dogs with AKI
buccal mucosal bleeding time (BMBT) was marginally prolonged in dogs with AKI, there was no correlation between BMBT and any other variables
Summary
Acute kidney injury (AKI) represents a spectrum of acute diseases, encompassing a continuum of functional and parenchymal damage. Methods: Prospective study comparing PCV, platelet count, platelet aggregometry (Multiplate), and von Willebrand factor antigen to collagen binding activity ratio (vWF:Ag:vWF:CBA) in 2 groups of dogs (AKI group versus controls). Platelet count was significantly higher in the AKI (350.5 × 103/μL [301, 516]) than in the control (241 × 103/μL [227, 251]; P = .01) group. Collagen-activated platelet aggregometry measured as area under the curve was significantly lower in the AKI (36.9 ± 17.7) than in the control (54.9 ± 11.2; P = .05) group. VWF:Ag:vWF:CBA was significantly higher in the AKI (2.2 [1.9, 2.6]) than in the control (1.1 [1.1, 1.2]; P = .01) group. Conclusions and Clinical Importance: Dogs with AKI had decreased collagenactivated platelet aggregation and appear to have a type II von Willebrand diseaselike phenotype as indicated by the high vWF:Ag:vWF:CBA
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