Platelet reactivity in chronic obstructive pyelonephritis: role of adrenaline in the pathogenesis of complications

Purpose. Evaluation of platelet reactivity and determination of the role of adrenaline in the initiation of the acute inflammatory response and severity of hematuria in patients with chronic obstructive pyelonephritis (Cop). Material and Methods. The study included 42 patients, 13 with remission of cop, and 29 - with cop relapse. All patients were treated with nonsteroidal anti-inflammatory drugs and antibiotics for at least 5-Ю days prior to the date of hospitalization. Platelets were isolated by centrifugation of citrated peripheral blood. Evaluation of platelet aggregation was performed by Chrono-Log Platelet Aggregometer (usa) using agonists (ADP, epinephrine, PAF, serotonin, collagen) in EC50 concentration. Results. In patients with cop relapse, reaction of peripheral blood reflects the presence of acute inflammation in the urinary tract, which provokes more pronounced hematuria than in chronic inflammation, specific to disease remission. The analysis of remission and relapse phases of cop has revealed platelet hyporeactivity on agonists studied. It was found that the potentiation of the stimulating effects of epinephrine and ADP causes an increase in the functional activity of hyporeactive platelets and is aimed to restriction of hematuria, while the interaction of adrenaline and PAF can provide the growing influence of leukocytes to platelets to initiate acute inflammation in cop. Conclusion. The interaction of different agonists in phases of cop remission and relapse can restore the function of hyporeactive platelets, with the adrenaline acts as a modulator in the pathogenetic mechanisms of cop complications.

chronic obstructive pyelonephritis, platelet reactivity, adrenaline, acute inflammation, hematuria