VWF and anemia (phenotype): Anemia, which is frequent in ESKD patients, increases the risk of bleeding because of diminished platelet function caused by reduced vessel–wall interaction (as a result of a decreased number of erythrocytes pushing platelets towards the vessel wall), an impaired release of ADP stimulated by erythrocytes, and less scavenging of NO by hemoglobin.3,16 Higher VWF levels in uremic patients compensate the relative adhesion defect to some extent,17 but altogether, these interactions result in thrombocytopathy and a subsequently impaired primary hemostasis.