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Nephrol Dial Transplant (1989) 4: 971-974
© 1989 European Renal Association-European Dialysis and Transplant Association

research-article

Hyperparathyroidism Does Not Influence the Abnormal Primary Haemostasis in Patients with Chronic Renal Failure

G. Viganò1, E. Gotti2, E. Comberti3, A. Giangrande4, R. Trevisan5 and G. Remuzzi1,2,

1Istituto di Ricerche Farmacologiche ‘Mario Negri’ Bergamo Italy 2Divisione di Nefrologia e Dialisi, Ospedali Riuniti di Bergamo Italy 3Istituto di Chimica, Facoltà di Medicina, Università di Brescia Brescia, Italy 4Divisione di Nefrologia e Dialisi, Ospedale Provinciale Busto Arsizio, Italy 5Cattedra di Patologia Medica e di Malattie del Ricambio, Policlinico Universitario Padova, Italy

Correspondence and offprint requests to: Correspondence and offprint requests to: Giuseppe Remuzzi MD, Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via Gavazzeni, 11, 24100 Bergamo, Italy

Patients with chronic renal failure suffer from secondary hyperparathyroidism and have greatly increased blood concentrations of intact parathyroid hormone (PTH) and PTH fragments. Thus PTH has been regarded in the last few years as a uraemic toxin possibly responsible for many clinical manifestations of the uraemic syndrome including a tendency to prolonged bleeding. Since PTH inhibits platelet aggregation ‘in vitro’, the possibility that hyperparathyroidism of uraemia plays a role in the pathogenesis of uraemic bleeding has been considered. Clinical data to support this possibility is not available so far. In this study we have correlated the skin bleeding time, the best clinical marker of uraemic bleeding tendency, with serum concentrations of intact PTH or PTH fragments in 40 patients with chronic renal failure undergoing chronic haemodialysis. Since the skin bleeding time is known to be influenced by packed cell volume (PCV), we also considered two distinct groups of uraemic patients on the basis of their PCV values. The results indicated that bleeding time does not correlate with serum concentrations of intact PTH or PTH fragments. Also, no correlation has been found between PTH values and blood concentrations of calcium, phosphorus, magnesium and hydroxyproline. It is concluded that elevated PTH values in renal-failure patients do not contribute to uraemic platelet defect, as reflected by the skin bleeding time.

Keywords: Bleeding time; Parathyroid hormone; Uraemic bleeding


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