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Bleeding time, platelet retention on glass beads, and ristocetin- induced platelet agglutination (RIPA) in platelet-rich plasma were simultaneously determined for 20 patients with chronic renal failure and previous hemorrhagic history. In seven patients chosen at random out of a group of 16 in whom the three tests were abnormal, RIPA of uremic-isolated platelets in presence of normal platelet-poor plasma (PPP) and of normal platelets in presence of patient PPP were performed. In all cases, the first assay showed diminished agglutination, suggesting a platelet defect; however, uremic PPP did not inhibit the agglutination of normal platelets. In the same patients, the interaction of platelets with subendothelium was evaluated using Baumgartner's perfusion method. The subendothelial surface covered by platelets was significantly decreased in experiments with uremic whole blood when compared to normal …