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Platelet microaggregates and release of endogenous prostacyclin during the initial phase of haemodialysis.

In six patients arterial blood samples were withdrawn during haemodialysis (HD) for the measurement of platelet microaggregates, platelet and leucocyte counts, pO2 and 6-oxo-PGF1 alpha (the stable metabolite of prostacyclin). During the initial phase of HD the plasma concentrations of 6-oxo-PGF1 alpha increased, indicating an increased release of endogenous prostacyclin. Coincidentally to this phenomenon, hypoxaemia, reduction in platelet and leucocyte counts, and an increase in number of platelet microaggregates could be observed. Since prostacyclin is able to resolve platelet aggregates, we interpret the increased prostacyclin release to be in part a self protection mechanism against embolisation of microaggregates released from the dialyser into lung and peripheral vascular systems.