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Thrombotic cardiovascular events are one of the main causes of morbidity and mortality in dialysis patients and vascular access thrombosis remains the Achilles ´ heel for patients undergoing maintenance hemodialysis (HD). HD and uremia are characterized by two simultaneous but opposite hematological abnormalities: a thrombotic predisposition and a bleeding tendency mainly due to impaired platelet-platelet and platelet-vessel wall interactions.