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Related Experiment Videos

Coagulation abnormalities in chronic peritoneal dialysis.

C L Jones1, M Andrew, A Eddy

  • 1Department of Paediatrics (Nephrology), Hospital for Sick Children, Toronto, Ontario, Canada.

Pediatric Nephrology (Berlin, Germany)
|March 1, 1990
PubMed
Summary
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Children on chronic peritoneal dialysis exhibit a hypercoagulable state, with altered coagulation and fibrinolytic factors. This may contribute to thrombosis risk, particularly following renal transplantation.

Area of Science:

  • Pediatric Nephrology
  • Hematology
  • Clinical Chemistry

Background:

  • Chronic peritoneal dialysis (CPD) is a treatment for pediatric kidney failure.
  • The potential for a hypercoagulable state in children on CPD is not well understood.
  • Understanding coagulation changes is crucial for managing complications like thrombosis.

Purpose of the Study:

  • To investigate the presence of a hypercoagulable state in children undergoing CPD.
  • To assess various coagulation and fibrinolytic factor levels in this patient group.

Main Methods:

  • Measured coagulation and fibrinolytic factors in 17 children on CPD.
  • Compared patient values to established reference ranges.
  • Analyzed correlations between dialysis duration and specific factor concentrations.

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Main Results:

  • Significantly increased activities of factors VII and VIII, and concentrations of von Willebrand factor (vWF), fibrinogen, factor XIIIA, and factor XIIIS were observed.
  • Prolonged activated partial thromboplastin time and decreased thrombin clotting time were noted.
  • Decreased plasminogen and increased alpha-2-antiplasmin concentrations indicated altered fibrinolysis.
  • Low plasma albumin was present in most patients; dialysis duration correlated with vWF and factor VII levels.
  • Two patients experienced clinical thrombotic episodes.

Conclusions:

  • Children on CPD demonstrate significant coagulation and fibrinolytic abnormalities, suggesting a hypercoagulable state.
  • These hemostatic alterations may play a role in the pathogenesis of thrombosis in patients with end-stage renal disease.
  • Further research is warranted to explore the clinical implications and management strategies for thrombosis in this population.