Plasma beta-thromboglobulin and platelet factor 4 in patients with chronic renal failure and effect of hemodialysis.

Significantly increased levels of plasma beta-thromboglobulin (beta-TG) (76.8 +/- 25.5 ng/ml, p less than 0.01) were observed in 24 patients with chronic renal failure (blood urea nitrogen (BUN) greater than 20 mg/100 ml), as compared with normal subjects (13.2 +/- 5.6 ng/ml). The increase in beta-TG was highly correlated with BUN (r = 0.651, p less than 0.01), creatinine (r = 0.778, p less than 0.01) and creatinine clearance ( t = -0.723, p less than 0.01). Plasma platelet factor 4 (PF4) and normal 5.0 +/- 2.0 ng/ml) also increased significantly to 8.5 +/- 3.4 ng/ml (p less than 0.01). However, statistical correlation between beta-TG and PF4 was not found in these patients. The reason is thought to be due to differences in molecular weight (PF4 8,000 MW; beta-TG 36,000 MW) and half-life time (PF4 30 min; beta-TG 100 min), and due to the difficulty in calculating statistically the correlation because of the narrow distribution of PF4 levels. The high levels of beta-TG (89.4 +/- 3.4 ng/ml) showed a further increase (109.4 +/- 5.8 ng/100 ml, p less than 0.01) after dialysis. This is thought to be due to hemoconcentration, because other blood factors such as RBC, WBC, platelets, fibrinogen, etc were elevated by about 20% during hemodialysis and because no adhesion of platelets to the cellulose membrane did occur. The increase in PF4 levels at 15 min (55.2 +/- 19.6 ng/ml, p less than 0.01) and 1 hr (23.7 +/- 8.4 ng/ml, p less than 0.01) of hemodialysis from the level before it (7.7 +/- 1.3 ng/ml) is thought to be caused the effect of heparin infusion. The change in PF4 was not accompanied by the change in beta-TG. During hemodialysis the decrease of other platelet functions such as adhesiveness, aggregation induced by ADP, collagen and PF3 remained unchanged.