Department of Nephrology, Jilin University Second Hospital, Changchun, China.
Ther Apher Dial. 2020 Aug;24(4):352-360. doi: 10.1111/1744-9987.13448. Epub 2019 Dec 2.
Hemodialysis (HD) is the most important treatment for patients with end-stage renal disease (ESRD). Thrombocytopenia is a potential treatment complication related to dialysis. Under normal circumstances, the platelet count would slightly decrease within the first hour of HD, but get restored towards the end of procedure. In most patients, the platelet count can be maintained within the normal range, and the occurrence of thrombocytopenia is relatively rare in clinical practice. Therefore, the possibility of thrombocytopenia in HD patients is often ignored. Moreover, thrombocytopenia might be misdiagnosed and mistreated. At present, almost all articles on the subject, apart from some case reports, focus on pseudothrombocytopenia and heparin-induced thrombocytopenia. In this review, we summarized various underlying causes, mechanisms, and diagnostic approaches to thrombocytopenia in HD patients. The review aims to provide a guide for clinicians interested in the causes and adequate treatment of thrombocytopenia.
血液透析（HD）是终末期肾病（ESRD）患者最重要的治疗方法。血小板减少症是一种与透析相关的潜在治疗并发症。在正常情况下，HD 开始后的第一个小时内血小板计数会略有下降，但在治疗结束时会恢复。在大多数患者中，血小板计数可以维持在正常范围内，临床上血小板减少症的发生率相对较低。因此，HD 患者发生血小板减少症的可能性通常被忽视。此外，血小板减少症可能被误诊和误治。目前，除了一些病例报告外，几乎所有关于该主题的文章都集中在假性血小板减少症和肝素诱导的血小板减少症上。在这篇综述中，我们总结了 HD 患者血小板减少症的各种潜在原因、机制和诊断方法。该综述旨在为关注血小板减少症病因和适当治疗的临床医生提供指导。
