Indoxyl sulfate, a uremic trigger for platelets

Portable, Intelligent Fluorescence Sensing Platform for Dense Convolutional Network-Capable Detection of Indophenol Sulfate and Methylmalonic Acid Using a Luminescent Eu@HOF Film

Indophenol sulfate (IS) and methylmalonic acid (MMA) are biomarkers of chronic kidney disease (CKD) and diabetes polyneuropathy (DPN), respectively. Portable and accurate monitoring of IS and MMA is very important to ensuring human health. The dense convolutional network (DenseNet) with image recognition has great potential in fluorescence sensing, but developing a platform with high precision and portability to diagnose the disease still faces huge challenges. Herein, we developed a high-sensitivity platform with a fluorescence material, a smartphone, and the DenseNet to monitor IS and MMA. A red-emitting Eu@PFC-13 (1) is prepared, and 1 shows high selectivity and low detection limits (DLs) to detect IS and MMA. The sensing mechanism of 1 toward IS and MMA is investigated by experiments and theoretical calculation. For detecting IS and MMA in serum and urine, 1 is fabricated into an Eu@PFC-13/AG (2) film with DLs of 1.4 and 1.6 μM, respectively. In addition, a portable smartphone platform is designed to monitor IS and MMA with high precision. Moreover, the DenseNet is constructed by Python, which can output the concentration of analytes by identifying fluorescence images and judge whether any is in a dangerous range. This work not only proposes a novel method that integrates a fluorescence material, a smartphone, and deep learning to detect analytes but also opens a new way for the diagnosis of CKD and DPN.

Roxadustat Does Not Affect Platelet Production, Activation, and Thrombosis Formation

Objective: Roxadustat is a new medication for the treatment of renal anemia. EPO (erythropoietin)-the current treatment standard-has been reported to enhance platelet activation and production. However, to date, the effect of roxadustat on platelets is unclear. To address this deficiency, herein, we have evaluated the effect of roxadustat on platelet production and function. Approach and Results: We performed several mouse platelet functional assays in the presence/absence of in vitro and in vivo roxadustat treatment. Both healthy and 5/6 nephrectomized mice were utilized. The effect of roxadustat on platelet function of healthy volunteers and chronic kidney disease patients was also evaluated. For platelet production, megakaryocyte maturation and proplatelet formation were assayed in vitro. Peripheral platelet and bone marrow megakaryocyte counts were also determined. We found that roxadustat could not stimulate washed platelets directly, and platelet aggregation, spreading, clot retraction, and P-selectin/JON/A exposure were similar with or without in vitro or in vivo roxadustat treatment among both healthy and 5/6 nephrectomized mice. In vivo mouse thrombosis models were additionally performed, and no differences were detected between the vehicle and roxadustat treatment groups. EPO, which was considered a positive control in the present study, promoted platelet function and production as reported previously. Megakaryocyte maturation and proplatelet formation were also not significantly different between control mice and those treated with roxadustat. After receiving roxadustat for 14 days, no difference in the peripheral platelet count was observed in the mice. Conclusions: Administration of roxadustat has no significant impact on platelet production and function.

Evaluation of platelet function in cats with and without kidney disease: a pilot study

OBJECTIVES

The aims of this study were to determine if stable chronic kidney disease (CKD) cats and uremic crisis cats have altered platelet function, and to determine the prevalence of positive fecal occult blood in CKD cats.

METHODS

Platelet function in normal cats, clinically stable International Renal Interest Society (IRIS) stage 2-4 CKD cats and CKD cats experiencing a uremic crisis were evaluated using impedance aggregometry. Area under the curve (AUC) at 6 mins was calculated for saline, adenosine diphosphate (AUCADP) and arachidonic acid (AUCASPI). The AUC in addition to hematocrit, platelet count and mean platelet volume (MPV) were compared between groups using the Kruskal-Wallis test followed by Dunn's post-hoc analysis. Guaiac fecal occult blood tests were performed on fecal samples and results were compared between groups using a χ2 for trend test.

RESULTS

AUCADP (P = 0.04) and AUCASPI (P = 0.05) were significantly higher in uremic crisis cats compared with normal cats at 6 mins. Hematocrit was significantly higher in normal cats when compared with IRIS stage 3 and 4 (P = 0.002) and uremic crisis (P = 0.0008) cats, with no difference among groups for platelet count or MPV. The proportion of cats with positive fecal occult blood samples was significantly different between groups (P = 0.0017); 50% uremic crisis cats, 33% IRIS stage 3 and 4 cats, and 10% IRIS stage 2 cats were positive, while no normal cats were positive. The proportion of cats with platelet clumping was significantly different between groups (P = 0.03).

CONCLUSIONS AND RELEVANCE

Platelet hyper-reactivity may be occurring in CKD cats experiencing a uremic crisis. The etiology of positive fecal occult blood samples in CKD cats is unclear and did not appear to be related to decreased platelet function as measured in this study and requires further investigation.