Age-related features of the regulation of the compensatory platelet response in hematuria in women with nephrolithiasis

Abstract

The aim of this study was to investigate the molecular mechanisms regulating platelet function in women of different ages with hematuria associated with the spontaneous elimination of calculi from the urinary tract. The study included 89 women with imaging-confirmed urinary tract calculi and verified hematuria. Platelet aggregation was assessed after incubation with ADP (a ligand of purinergic P2Y receptors), U-46619 (a stable thromboxane A₂ analog and TR receptor ligand), ATP (a ligand of purinergic P2X1 receptors), epinephrine (a non-selective α₂-adrenoreceptor ligand), type IV collagen (a GPVI receptor ligand), platelet-activating factor (a PAF receptor ligand), and adenosine (an A₂A receptor ligand). Platelet aggregation was measured using a ChronoLog analyzer (USA). Statistical analysis was performed using the MedCalc software package. The severity of microhematuria in Group 1 women was 49.2% higher (p < 0.001) than in Group 2 women. The study demonstrated that the stereotypical mechanism for increased platelet aggregation in hematuria associated with the spontaneous elimination of urinary tract stones is hyperreactivity of the PAF receptor and TR receptor. Specific regulation of the pro-aggregatory function of platelets in women of reproductive age is associated with activation of the P2X1 receptor, whereas in postmenopausal women it is linked to stimulation of the α₂-adrenoreceptor.