Abstract
BackgroundDialysis membranes that release nitric oxide (NO) from their surface, mimicking one of the functions of endothelial cells, may suppress platelet reactivity during hemodialysis treatment. The aim of the present study was to examine whether the addition of a NO donor to the dialysis fluid can suppress platelet reactivity during dialysis.MethodsPorcine whole blood was circulated for 4 h through a polysulfone (PS) dialyzer or polymethylmethacrylate (PMMA) dialyzer. After the blood was circulated through the blood circuit and dialyzer, sodium nitroprusside was added to the dialysis fluid as a NO donor. The changes in the platelet reactivity, measured by the platelet aggregation activity by the addition of adenosine diphosphate or collagen in the blood sample, were evaluated during ex vivo dialysis experiments in the presence of a dialysis fluid containing or not containing a NO donor.ResultsThe platelet aggregation activity was significantly decreased at 30 min after the start of the experiment in the case where nitroprusside was added to the dialysis fluid (the NO (+) condition) as compared to the case where no nitroprusside was added to the dialysis fluid (the NO (−) condition), for both the PS and PMMA membranes. The suppression of the platelet reactivity in the NO (+) condition was sustained until the end of the experimental period (240 min). The platelet cyclic guanosine monophosphate level was also significantly increased in the NO (+) condition as compared to the NO (−) condition.ConclusionsNO in the dialysis fluid appears to be capable of suppressing the increase of the platelet reactivity observed during dialysis.
Highlights
Hemodialysis is a widely adopted renal replacement therapy for patients with end-stage chronic kidney disease
The present study was aimed at examining whether nitric oxide (NO) released from a NO donor added to the dialysis fluid can suppress the platelet reactivity that is observed during ex vivo dialysis experiment
At the start of dialysis, there was no difference in the platelet aggregation activity between the two experimental conditions, namely, the NO (−) and NO (+) conditions
Summary
Hemodialysis is a widely adopted renal replacement therapy for patients with end-stage chronic kidney disease. Platelet reactivity, which is known to be increased in patients undergoing hemodialysis [6], has been reported to be positively correlated with the incidence of coronary artery disease [4, 7, 8]. We considered that if the surface of the dialysis membrane could release NO like endothelial cells, the platelet reactivity during hemodialysis might possibly be suppressed. The present study was aimed at examining whether NO released from a NO donor added to the dialysis fluid can suppress the platelet reactivity that is observed during ex vivo dialysis experiment. Dialysis membranes that release nitric oxide (NO) from their surface, mimicking one of the functions of endothelial cells, may suppress platelet reactivity during hemodialysis treatment. The aim of the present study was to examine whether the addition of a NO donor to the dialysis fluid can suppress platelet reactivity during dialysis
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