Successful kidney transplantation does not reverse the coagulopathy in patients with chronic renal failure on either

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Updated: Jul 15, 2026

Murine Kidney Transplant Technique
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Published on: October 20, 2015

A Ballow1, A M A Gader, S Huraib

  • 1Division of Nephrology, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|May 15, 2007
PubMed

Insights

Patients with chronic renal failure (CRF) exhibit coagulopathy, with hemodialysis (HD) showing more pronounced effects than continuous ambulatory peritoneal dialysis (CAPD). Kidney transplantation only partially corrects these hemostatic abnormalities.

Area of Science:

  • Nephrology
  • Hematology
  • Clinical Chemistry

Background:

  • Chronic renal failure (CRF) is associated with complex hemostatic dysfunctions.
  • Disagreement exists regarding the measurement of hemostatic parameters in CRF patients undergoing dialysis (hemodialysis [HD] or continuous ambulatory peritoneal dialysis [CAPD]).

Purpose of the Study:

  • To characterize coagulopathy in CRF patients before and after initiating HD or CAPD.
  • To assess the correction of CRF-associated coagulopathy after successful kidney transplantation.

Main Methods:

  • Cross-sectional and prospective study design.
  • Inclusion of 49 CRF patients (20 HD, 9 CAPD, 20 post-transplant) and 34 healthy controls.
  • Measurement of various hemostatic parameters including fibrinogen, AT III, protein C, protein S, F1+2, TAT, D-Dimer, tPA, and PAI-1.

Main Results:

  • Significant hyper-fibrinogenemia observed in all CRF groups.
  • HD patients showed elevated AT III, total protein S, and reduced free protein S and protein C compared to controls.
  • Elevated F1+2, TAT, and D-Dimer in HD and transplant groups; only D-Dimer increased in CAPD patients.
  • Coagulopathy was more pronounced in HD patients than CAPD patients and only partially corrected post-transplant.

Conclusions:

  • CRF is associated with significant activation of the hemostatic system.
  • Hemodialysis leads to more pronounced coagulopathy than CAPD.
  • Successful kidney transplantation offers only partial correction of CRF-related hemostatic abnormalities.

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