Evaluation Thrombocytosis in CKD Stage V Patient on  Hemodialysis Treatment : Case Report:

Putu Nindya Ayu Ningrum Subadra; I Wayan Sunaka

doi:10.37022/wjcmpr.v5i3.267

Putu Nindya Ayu Ningrum Subadra Department of Internal Medicine Wangaya General Public Hospital, Bali, Indonesia
I Wayan Sunaka Department of Internal Medicine Wangaya General Public Hospital, Bali, Indonesia

DOI https://doi.org/10.37022/wjcmpr.v5i3.267

Abstract

Chronic kidney disease (CKD), also known as renal failure, primarily affects people with a history of hypertension and diabetes. In this medical condition, the rate of filtration or kidney function can decrease over the course of a month or a year. Several studies have found an increase in pro-inflammatory cytokines in patients with CKD. Platelet dysfunction and hyperreactivity have been linked to chronic inflammation. When the platelet count exceeds 450,000/l, thrombocytosis occurs. It is also referred to as thrombocythemia. Reactive thrombocytosis accounts for 80-90% of all thrombocytosis events, with inflammation being one of the most common causes. We report a 67-year-old man presenting to the hospital with fever and weakness. The patient had a history of CKD stage V and currently was rceiving hemodialysis treatment. Laboratory finding showed patient had thrombocytosis. Further examination is required to determine the cause of thrombocytosis in CKD patient.

Keywords: Thrombocytosis, Chronic kidney disease, CKD, Hemodialysis, Treatment

Downloads

Download data is not yet available.

References

[1] Kelly DM, Ademi Z, Doehner W, et al. Chronic Kidney Disease and Cerebrovascular Disease: Consensus and Guidance From a KDIGO Controversies Conference. Stroke. 2021;52(7):e328-e346. doi:10.1161/STROKEAHA.120.029680]
[2] Braun MM, Khayat M. Kidney Disease: Chronic Kidney Disease. FP essentials. 2021;509(Suppl 1):20-25.]
[3] Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: Global dimension and perspectives. The Lancet. 2013;382(9888):260-272. doi:10.1016/S0140-6736(13)60687-X]
[4] Stemer G, Laml-wallner G, Kuegler I, et al. Comprehensive evaluation of clinical pharmacists ’ interventions in a large Austrian tertiary care hospital. Published online 2012:529-534. doi:10.1136/ejhpharm-2012-000131]
[5] Al-Shdaifat EA, Manaf MRA. The economic burden of hemodialysis in Jordan. Indian Journal of Medical Sciences. 2013;67(5):103-116. doi:10.4103/0019-5359.122734]
[6] Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet. 2020;395(10219):200-211. doi:10.1016/S0140-6736(19)32989-7]
[7] Hustrini NM, Susalit E, Rotmans JI. Prevalence and risk factors for chronic kidney disease in Indonesia: An analysis of the National Basic Health Survey 2018. Journal of global health. 2022;12:04071. doi:10.7189/jogh.12.04071]
[8] Darlington O, Dickerson C, Evans M, et al. Costs and Healthcare Resource Use Associated with Risk of Cardiovascular Morbidity in Patients with Chronic Kidney Disease: Evidence from a Systematic Literature Review. Advances in Therapy. 2021;38(2):994-1010. doi:10.1007/s12325-020-01607-4]
[9] Glassock RJ, Warnock DG, Delanaye P. The global burden of chronic kidney disease: Estimates, variability and pitfalls. Nature Reviews Nephrology. 2017;13(2):104-114. doi:10.1038/nrneph.2016.163]
[10] Schafer AI. Thrombocytosis. 2015;314(11):1171-1172.]
[11] Rachmadi D, Rudiansyah M, Bandiara RIA, Lubis L. A Narrative Review: The Inflammation in Chronic Kidney Disease (CKD). International Journal of Pharmaceutical Research. 2021;13(02):258-265. doi:10.31838/ijpr/2021.13.02.058]
[12] Drüeke TB, Massy ZA. Atherosclerosis in CKD: Differences from the general population. Nature Reviews Nephrology. 2010;6(12):723-735. doi:10.1038/nrneph.2010.143]
[13] Wattanakit K, Cushman M, Stehman-Breen C, Heckbert SR, Folsom AR. Chronic kidney disease increases risk for venous thromboembolism. Journal of the American Society of Nephrology. 2008;19(1):135-140. doi:10.1681/ASN.2007030308]
[14] Folsom AR, Lutsey PL, Astor BC, Wattanakit K, Heckbert SR, Cushman M. Chronic kidney disease and venous thromboembolism: A prospective study. Nephrology Dialysis Transplantation. 2010;25(10):3296-3301. doi:10.1093/ndt/gfq179]
[15] Mathew RO, Bangalore S, Lavelle MP, et al. Diagnosis and management of atherosclerotic cardiovascular disease in chronic kidney disease: a review. Kidney International. 2017;91(4):797-807. doi:10.1016/j.kint.2016.09.049]
[16] Sałacki AJ, Wysokiński A. Reactive thrombocytosis resulting from frequent blood donations as an extremely rare cause of st segment elevation myocardial infarction in the case of a 19-year-old male. Annals of Agricultural and Environmental Medicine. 2018;25(4):602-604. doi:10.26444/aaem/74196]
[17] Harrison CN, Bareford D, Butt N, et al. Guideline for investigation and management of adults and children presenting with a thrombocytosis. British Journal of Haematology. 2010;149(3):352-375. doi:10.1111/j.1365-2141.2010.08122.x]
[18] Toprak SK, Karakuş S, Şahin FI. Esansiyel trombositeminin genç erişkindeki akut trombotik komplikasyonu. Turkish Journal of Hematology. 2011;28(4):350-351. doi:10.5152/tjh.2011.70]
[19] Tóth L, Muszbek L, Komáromi I. Mechanism of the irreversible inhibition of human cyclooxygenase-1 by aspirin as predicted by QM/MM calculations. Journal of Molecular Graphics and Modelling. 2013;40:99-109. doi:10.1016/j.jmgm.2012.12.013]
[20] Molnar MZ, Streja E, Kovesdy CP, et al. High platelet count as a link between renal cachexia and cardiovascular mortality in end-stage renal disease patients. American Journal of Clinical Nutrition. 2011;94(3):945-954. doi:10.3945/ajcn.111.014639]
[21] Bleeker JS, Hogan WJ. Thrombocytosis : Diagnostic Evaluation , Thrombotic Risk Stratification , and Risk-Based Management Strategies. 2011;2011. doi:10.1155/2011/536062]
[22] Lutz J, Menke J, Sollinger D, Schinzel H, Thürmel K. Haemostasis in chronic kidney disease. Nephrology Dialysis Transplantation. 2014;29(1):29-40. doi:10.1093/ndt/gft209]
[23] Boccardo P, Remuzzi G, Galbusera M. Platelet dysfunction in renal failure. Seminars in Thrombosis and Hemostasis. 2004;30(5):579-589. doi:10.1055/s-2004-835678]
[24] Yang K, Du C, Wang X, et al. Indoxyl sulfate induces platelet hyperactivity and contributes to chronic kidney disease-associated thrombosis in mice. Blood. 2017;129(19):2667-2679. doi:10.1182/blood-2016-10-744060]
[25] Melgaard L, Overvad TF, Skjøth F, Christensen JH, Larsen TB, Lip GYH. Risk of stroke and bleeding in patients with heart failure and chronic kidney disease: a nationwide cohort study. ESC Heart Failure. 2018;5(2):319-326. doi:10.1002/ehf2.12256]
[26] Molnar AO, Bota SE, McArthur E, et al. Risk and complications of venous thromboembolism in dialysis patients. Nephrology Dialysis Transplantation. 2018;33(5):874-880. doi:10.1093/ndt/gfx212]
[27] Ocak G, Noordzij M, Rookmaaker MB, et al. Mortality due to bleeding, myocardial infarction and stroke in dialysis patients. Journal of Thrombosis and Haemostasis. 2018;16(10):1953-1963. doi:10.1111/jth.14254]
[28] Tripepi G, Mallamaci F, Zoccali C. Inflammation markers, adhesion molecules, and all-cause and cardiovascular mortality in patients with ESRD: Searching for the best risk marker by multivariate modeling. Journal of the American Society of Nephrology. 2005;16(3 SUPPL. 1):83-88. doi:10.1681/ASN.2004110972]
[29] Lalramenga PC, Gupta S, P N. Study of C-Reactive Protein Significance in Chronic Kidney Disease. International Journal of Contemporary Medical Research [IJCMR]. 2019;6(6):10-13. doi:10.21276/ijcmr.2019.6.6.48]
[30] Witarini Dewi MM, Herawati S, Mulyantari NK, Prabawa IPY. The comparison of erythrocyte sedimentation rate (ESR) modify Westergren Caretium Xc-A30 and Westergren Manual in Clinical Pathology Laboratory, Sanglah General Hospital, Denpasar, Bali. Bali Medical Journal. 2019;8(2):487-490. doi:10.15562/bmj.v8i2.1401]
[31] Alsomaili MI braheem, Yousuf M, Hejaili F, Almotairi W, Al-Sayyari AA. Erythrocyte sedimentation rate in stable patients on chronic hemodiaysis. Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia. 2015;26(6):1149-1153. doi:10.4103/1319-2442.168589]
[32] Gupta J, Mitra N, Kanetsky PA, et al. Association between albuminuria, kidney function, and inflammatory biomarker profile in CKD in CRIC. Clinical journal of the American Society of Nephrology : CJASN. 2012;7(12):1938-1946. doi:10.2215/CJN.03500412]
[33] Shankar A, Sun L, Klein BEK, et al. Chronic Kidney Disease : a Population-Based Cohort Study. 2012;80(11):1231-1238. doi:10.1038/ki.2011.283.Markers]
[34] Lee BT, Ahmed FA, Lee Hamm L, et al. Association of C-reactive protein, tumor necrosis factor-alpha, and interleukin-6 with chronic kidney disease Epidemiology and Health Outcomes. BMC Nephrology. 2015;16(1):1-6. doi:10.1186/s12882-015-0068-7]
[35] Pecoits-Filho R, Heimbürger O, Bárány P, et al. Associations between circulating inflammatory markers and residual renal function in CRF patients. American Journal of Kidney Diseases. 2003;41(6):1212-1218. doi:10.1016/S0272-6386(03)00353-6]
[36] Caglar K, Peng Y, Pupim LB, et al. Inflammatory signals associated with hemodialysis. Kidney International. 2002;62(4):1408-1416. doi:10.1046/j.1523-1755.2002.00556.x]
[37] Nowak KL, Chonchol M, Ikizler TA, et al. IL-1 Inhibition and Vascular Function in CKD. Published online 2016:1-10. doi:10.1681/ASN.2016040453]
[38] Jurk K. Analysis of platelet function and dysfunction. Hamostaseologie. 2015;35(1):60-72. doi:10.5482/hamo-14-09-0047]
[39] Waki K, Hayashi A, Ikeda S, et al. Measuring Platelet Aggregation in Dialysis Patients With a Whole Blood Aggregometer by the Screen Filtration Pressure Method. Therapeutic Apheresis and Dialysis. 2011;15(2):203-206. doi:10.1111/j.1744-9987.2010.00899.x]
[40] Doig K, Butina M. FOCUS : IN TERPRETING T HE COMPLETE BLOOD CO UNT A Methodical Approach to Interpreting the Platelet Parameters of the Complete Blood Count.]
[41] Falchi L, Kantarjian HM, Verstovsek S. Assessing the Thrombotic Risk of Patients with Essential Thrombocythemia in the Genomic Era. 2018;31(9):1845-1854. doi:10.1038/leu.2017.150.Assessing]
[42] Elani Streja, MPH, Csaba P Kovesdy, MD, Sander Greenland, DrPH JDK, MD, Charles J McAllister, MD, Allen R Nissenson, MD, and Kamyar Kalantar-Zadeh MMP. Erythropoietin, Iron Depletion and Relative Thrombocytosis: A Possible Explanation for Hemoglobin-Survival Paradox in Chronic Kidney Disease. 2017;52(4):727-736. doi:10.1053/j.ajkd.2008.05.029.Erythropoietin]

Evaluation Thrombocytosis in CKD Stage V Patient on Hemodialysis Treatment : Case Report