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Semin Thromb Hemost 2023; 49(05): 507-522
DOI: 10.1055/s-0042-1757167
Review Article

Platelet Function in Acute Kidney Injury: A Systematic Review and a Cohort Study

Jeppe Lundholm Stadarfeld Jensen
1   Department of Clinical Biochemistry, Thrombosis and Haemostasis Research Unit, Aarhus University Hospital, Aarhus, Denmark
,
Claus Vinter Bødker Hviid
1   Department of Clinical Biochemistry, Thrombosis and Haemostasis Research Unit, Aarhus University Hospital, Aarhus, Denmark
2   Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
,
Christine Lodberg Hvas
3   Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
4   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
Steffen Christensen
3   Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
4   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
Anne-Mette Hvas
1   Department of Clinical Biochemistry, Thrombosis and Haemostasis Research Unit, Aarhus University Hospital, Aarhus, Denmark
4   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
Julie Brogaard Larsen
1   Department of Clinical Biochemistry, Thrombosis and Haemostasis Research Unit, Aarhus University Hospital, Aarhus, Denmark
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Abstract

Acute kidney injury (AKI) patients have increased bleeding risk, which could be partially due to acquired platelet dysfunction. We conducted a systematic review and a cohort study to investigate platelet function and count in AKI and their association with AKI-related bleeding and mortality. Through a systematic literature search in PubMed and Embase, we identified 9 studies reporting platelet function and 56 studies reporting platelet count or platelet indices in AKI patients. Overall, platelet aggregation was reduced in AKI patients in nonintensive care unit (ICU) settings but not in ICU settings, except that reduced aggregation was associated with renal replacement therapy. Thrombocytopenia in AKI was frequent and often predictive of mortality. In our cohort study, we prospectively included 54 adult ICU patients who developed AKI within 24 hours of ICU admission and 33 non-AKI ICU controls. Platelet function was measured with light transmission aggregometry and flow cytometry. AKI patients bled more frequently than non-AKI patients (p = 0.04), and bleeding was associated with increased 30-day mortality in AKI (p = 0.02). However, platelet function was not different between AKI and non-AKI patients (aggregation: all p > 0.52; flow cytometry: all p > 0.07) and platelet function was not associated with bleeding in AKI. In conclusion, a reduced platelet count is frequent in AKI, but the literature on platelet function in AKI is sparse. In a cohort study, we demonstrated that patients with AKI within 24 hours of ICU admission exhibited increased bleeding tendency but this was not associated with reduced platelet function.

Keywords

Acute kidney injury - intensive care unit - platelet function tests - platelet activation - bleeding

Supplementary Material



Publication History

Article published online:
29 September 2022

© 2022. Thieme. All rights reserved.

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