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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Predictors Of Thrombogenesis By The State Of Pro- And Anticoagulant Components Of Hemostasis In The Patients With
Olexiy B Storozhuk1, Iryna B Seleznyova2, Larisa O Storozhuk2
1Vinnytsia National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
Insights
Patients with stage V chronic kidney disease (CKD) on hemodialysis often experience clotting issues. Measuring thrombogenesis activators and inhibitors can help identify thrombosis risk in these patients.
Area of Science:
- Nephrology
- Hematology
- Thrombosis Research
Background:
- Stage V chronic kidney disease (CKD) patients on hemodialysis face high risks of thrombosis due to hemostatic disturbances.
- Identifying early predictors of thrombosis is challenging due to inflammation and antibody accumulation.
Purpose of the Study:
- To evaluate the utility of thrombogenesis activators and inhibitors as markers for thrombophilia in hemodialysis patients with stage V CKD.
Main Methods:
- Studied 88 patients (52 male, 36 female) with stage V CKD undergoing program hemodialysis.
- Assessed key hemostatic markers: soluble fibrin, D-dimer, protein C, and fibrinogen.
Main Results:
- A significant increase in soluble fibrin and fibrinogen was observed in two-thirds of patients.
- Natural anticoagulant protein C levels decreased, while D-dimer showed a tendency to decrease.
- Female patients exhibited increased D-dimer alongside higher soluble fibrin levels.
Conclusions:
- Comprehensive assessment of thrombogenesis activators and inhibitors can indicate thrombophilia in long-term hemodialysis patients.
- Elevated soluble fibrin and fibrinogen, coupled with decreased protein C, are common findings.
- These markers offer potential for early detection of thrombosis risk in CKD patients.
Objective:
Introduction: One of the major complications of stage V chronic kidney disease (CKD), treated by program hemodialysis, are hemostatic system disturbances resulting in thrombosis development. To detect early predictors of potential thrombosis in study category of patients is rather difficult because of inflammatory process, accumulation of antibodies, continuous damage of blood elements. The aim: To estimate potential applicability of activators and inhibitors of thrombogenesis as thrombophilia markers in the patients with stage V CKD, treated by program hemodialysis.
Patients And Methods:
Materials and methods:88 patients (52 males and 36 females) with stage V CKD, treated by program hemodialysis, were studied. Hemostatic profile was estimated in all the patients (soluble fibrin, D-dimer, protein C, fibrinogen).
Results:
Results: Two thirds of the patients with stage V CKD, treated by program hemodialysis, had significant increase in soluble fibrin and fibrinogen concentration against the background of decrease of natural anticoagulant - protein C and disparate response of D-dimer (tendency to decrease). It was established that comprehensive estimation of activators and inhibitors of thrombogenesis can become an indicator of thrombophilias in the patients with stage V CKD, treated by long term hemodialysis.
Conclusion:
Conclusions: The majority of patients (68.2%) with stage VD CKD, treated by long term hemodialysis, had significant increase of soluble fibrin level (р <0.02) along with decreased D-dimer to borderline values. In general group of patients there was significant decrease of protein C (р<0.05) on the background of great increase of fibrinogen concentration in the majority of patients (62%) (р <0.001). The females were found to have significant increase of D-dimer level (р <0.05) along with the increase of soluble fibrin concentration. Comprehensive determination of activators and inhibitors of thrombogenesis can serve an indicator of thrombophilias in the patients with stage VD CKD, treated by program hemodialysis.
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