Primary hemostatic function in dogs with acute kidney injury.

Abstract

BACKGROUND: Bleeding tendencies can occur with uremia. OBJECTIVES: To characterize primary hemostatic function in dogs with acute kidney injury (AKI). ANIMALS: Ten dogs with International Renal Interest Society AKI grade III or above and 10 healthy controls. METHODS: Prospective study comparing PCV, platelet count, platelet aggregometry (Multiplate), and von Willebrand factor antigen to collagen binding activity ratio (vWF:Ag:vWF:CBA) in 2 groups of dogs (AKI group versus controls). Buccal mucosal bleeding time was measured in the AKI group only. Data are presented as median [25th, 75th percentile] unless otherwise stated. Significance was set at P&#x2009;<&#x2009;.05. RESULTS: Mean PCV was significantly lower in the AKI (34.7%; &#xb1;SD, 8.8) than in the control (46.1%; &#xb1;SD, 3.6; P&#x2009;<&#x2009;.001) group. Platelet count was significantly higher in the AKI (350.5&#x2009;&#xd7;&#x2009;10/&#x3bc;L [301, 516]) than in the control (241&#x2009;&#xd7;&#x2009;10/&#x3bc;L [227, 251]; P = .01) group. Collagen-activated platelet aggregometry measured as area under the curve was significantly lower in the AKI (36.9&#x2009;&#xb1;&#x2009;17.7) than in the control (54.9&#x2009;&#xb1;&#x2009;11.2; P = .05) group. vWF:Ag:vWF:CBA was significantly higher in the AKI (2.2 [1.9, 2.6]) than in the control (1.1 [1.1, 1.2]; P = .01) group. There was a strong correlation between vWF:Ag:vWF:CBA and creatinine (r = 0.859; P&#x2009;<&#x2009;.001), but no other variables. CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with AKI had decreased collagen-activated platelet aggregation and appear to have a type II von Willebrand disease-like phenotype as indicated by the high vWF:Ag:vWF:CBA.