The effect of long term, low-dose tranexamic acid treatment on platelet dysfunction and haemoglobin levels in haemodialysis patients

Mišo Šaboviã; Irena Preložnik Zupan; Barbara Salobir; Igor Zupan; Peter Černelã; Janez Lavre; Bojan Vujkovac

doi:10.1160/TH05-02-0123

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 94(06): 1245-1250
DOI: 10.1160/TH05-02-0123

Platelets and Blood Cells

Schattauer GmbH

The effect of long term, low-dose tranexamic acid treatment on platelet dysfunction and haemoglobin levels in haemodialysis patients

Authors

Mišo Šaboviã

¹Department of Vascular Diseases, University Medical Centre, Ljubljana, Slovenia
Irena Preložnik Zupan

²Department of Haematology, University Medical Centre, Ljubljana, Slovenia
Barbara Salobir

¹Department of Vascular Diseases, University Medical Centre, Ljubljana, Slovenia
Igor Zupan

³Department of Cardiology, University Medical Centre, Ljubljana, Slovenia
Peter Černelã

²Department of Haematology, University Medical Centre, Ljubljana, Slovenia
Janez Lavre

⁴Department of Nephrology and Dialysis, Slovenj Gradec General Hospital, Slovenia
Bojan Vujkovac

⁴Department of Nephrology and Dialysis, Slovenj Gradec General Hospital, Slovenia

Abstract

Summary

Some previous studies suggest that activation of the fibrinolytic system may induce platelet dysfunction in haemodialysis patients. Accordingly, inhibition of fibrinolysis may improve platelet dysfunction, and speculatively increase haemoglobin levels. We tested this hypothesis. The study group comprised 22 patients (14 male, 8 female, median age 62), who had been on maintenance haemodialysis for more than one year. Patients were treated for three months with low-dose tranexamic acid (TXA), a potent anti-fibrinolytic agent. The dosages of erythropoietin and the haemodialysis procedure were not changed significantly during the study. We primarily followed platelet function (by in vitro closure time test) and haemoglobin values. Patients were divided into those with substantially prolonged (N=9) and those with slightly delayed or normal (N=13) in vitro closure time. Treatment with TXA resulted in a significant improvement of platelet function and increased levels of haemoglobin in the first group, and no changes in either platelet function or haemoglobin values in the second group. TXA in the dosage used was biologically active, since a significant decrease in plasminogen and D-dimer were found in both groups. No significant changes in other fibrinolytic parameters or von Willebrand factor were found. No complications in terms of arterial or venous thrombosis were observed. Our pilot study suggests that long term, low-dose TXA treatment of haemodialysis patients with substantially prolonged in vitro closure time results in a significant improvement of platelet dysfunction and a significant increase in haemoglobin values. These new, promising results merit further investigation in larger studies.

Keywords

Tranexamic acid - platelet - haemoglobin - haemodialysis patients

Full Text

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