Platelets and Renal Disorders
Platelets and Renal Disorders
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DOI：
10.1007/978-3-319-47462-5_79
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
J. Lutz;K. Jurk
中科院分区：
文献类型：
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作者：
J. Lutz;K. Jurk
慢性肾病（CKD）患者血栓形成和出血发作的风险增加。血小板活化、血小板-白细胞缀合物和血小板衍生的微粒连同内皮细胞的活化都可以在血小板中赋予促血栓形成作用。此外，血小板可导致CKD患者的炎症状态，因此与其血栓形成促进作用一起也可导致这些患者的心血管风险增加。尿毒症毒素浓度升高、贫血和内皮细胞功能改变均可导致血小板功能受损，从而增加CKD患者的出血风险。然而，血小板也可以直接参与肾脏疾病的发病机制，如血栓性微血管病、免疫复合物介导的肾脏疾病、抗GBM肾小球肾炎和肾移植后抗体介导的排斥反应，因为它们在活化后可以促进炎症反应。以下章节概述了CKD患者血小板血栓形成和促出血作用的机制，以及血小板在几种肾脏疾病中直接致病作用的机制。
Patients with chronic kidney disease (CKD) have an increased risk of thrombosis as well as bleeding episodes. Platelet activation, platelet–leukocyte conjugates and platelet-derived microparticles together with an activation of endothelial cells can all confer pro-thrombotic effects in platelets. Furthermore, platelets can contribute to the inflammatory state in patients with CKD and thus together with their thrombosis promoting effect can also contribute to the increased cardiovascular risk of these patients. The bleeding risk in patients with CKD can be augmented by increased concentrations of uraemic toxins, anaemia and altered endothelial cell function all contributing to an impaired platelet function. However, platelets can also be directly involved in the pathogenesis of renal diseases such as thrombotic microangiopathy, immune complex-mediated renal disease, anti-GBM glomerulonephritis and antibody-mediated rejection after kidney transplantation as they can promote inflammatory responses after their activation. The following chapter gives an overview about the mechanisms involved in thrombosis and bleeding promoting effects of platelets in patients with CKD as well as the mechanisms behind the direct pathogenic effects of platelets in several renal diseases.