Background and aims The aim of the study was to assess the safety of regional anesthesia in end-stage renal disease patients related to platelet function.

Methods The study included patients with ESRD on two different types of renal replacement therapy (HD; PD), which were treated in the Department of Nephrology, Hypertension, Dialysis and Transplantation in Clinical Hospital Center Zagreb, during a 3-month period. During the regular visit, together with blood sampling for standard laboratory parameters, an additional 2 ml of blood was taken from all patients who met the inclusion criteria, after providing the informed consent. Platelet function testing was performed on platelet function analyzer (PFA-200) that ‘in vitro’ simulates the process of aggregation and platelet activation. Results are reported as the closure time in seconds for COL-EPI and COL-ADP cartridges. Data for analysis were taken from the medical records. Control group included healthy individuals.

Results The study included 44 patients with ESRD undergoing regular HD (n=32) or PD (n=12). Although there were no significant differences in COL/EPI and COL/ADP tests, more than 50% of HD patients had COL/EPI test values above the upper limit indicating abnormalities in platelet aggregation. Those findings correlate with higher chance for bleeding in HD group.

Conclusions According to the results of this study, platelet function testing in ESRD patients, prior to regional anesthesia, could support the safety of the procedure. Clinical relevance of these findings should be further investigated.