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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.4K

Evaluation of novel coagulation and platelet function assays in patients with chronic kidney disease

Alyaa Abdelmaguid1,2,3, Lara N Roberts4, Laura Tugores5

  • 1Department of Women and Children's Health, King's College London, London, UK.

Journal of Thrombosis and Haemostasis : JTH
|January 24, 2022
PubMed

Insights

Chronic kidney disease (CKD) patients show increased clotting (hypercoagulability) and impaired platelet function. Estimated glomerular filtration rate (eGFR) independently influences these hemostasis abnormalities in CKD.

Area of Science:

  • Nephrology
  • Hematology
  • Clinical Chemistry

Background:

  • Hemostasis evaluation is crucial for managing bleeding and thrombotic risks in chronic kidney disease (CKD).
  • Standard coagulation tests are insufficient for detecting coagulopathy in CKD patients.
  • Novel assays are needed to accurately assess hemostasis in CKD.

Purpose of the Study:

  • To investigate hemostasis parameters in patients across various stages of chronic kidney disease (CKD).
  • To utilize advanced coagulation assays for a comprehensive hemostasis evaluation in CKD.
  • To correlate hemostasis findings with estimated glomerular filtration rate (eGFR) in CKD.

Main Methods:

  • Cross-sectional study involving 120 CKD patients and 30 healthy controls (HC).
  • Utilized standard coagulation tests alongside rotational thromboelastometry (ROTEM), multiple electrode aggregometry (MEA), and thrombin generation assays.
  • Measured biomarkers including D-dimer, thrombin-antithrombin (TAT), and intercellular adhesion molecule-1 (ICAM-1).

Main Results:

  • CKD patients exhibited elevated D-dimer, TAT, and ICAM-1 levels compared to HC (P < .01).
  • ROTEM showed significantly higher maximum clot firmness in CKD patients (P < .01).
  • Stage 5 CKD patients displayed impaired platelet aggregation (MEA) and prolonged thrombin generation times.

Conclusions:

  • CKD patients present with concurrent hypercoagulability (ROTEM) and platelet dysfunction (MEA).
  • Estimated glomerular filtration rate (eGFR) is an independent determinant of both hypercoagulability and platelet dysfunction in CKD.
  • Advanced coagulation assays provide critical insights into CKD-associated hemostatic abnormalities.
Abstract

Keywords:
chronic kidney diseaseend-stage kidney diseasehypercoagulabilityplatelet aggregationthromboelastometry

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