Jul 3, 2020

Acute kidney injury in decompensated cirrhosis is associated with both hypo- and hyper-coagulable features

Hepatology : Official Journal of the American Association for the Study of Liver Diseases
Alberto ZanettoGuadalupe Garcia-Tsao

Abstract

Recent evidence suggests that acute kidney injury (AKI) is the main predictor of post-paracentesis bleeding in patients with cirrhosis. To assess factors responsible for bleeding tendency in AKI, we performed a prospective study comparing all three aspects of hemostasis (platelets, coagulation, fibrinolysis) in patients with decompensated cirrhosis with and without AKI. Primary hemostasis assessment included platelet aggregation and secretion (platelet function markers) and von Willebrand factor (VWF). Secondary hemostasis assessment included pro-coagulant (Factor VIII, Factor XIII) and anti-coagulant (protein C, protein S, and antithrombin) factors and thrombin generation (TG). Tertiary hemostasis assessment included fibrinolytic factors and plasmin-antiplasmin complex (PAP). Eighty patients with decompensated cirrhosis were recruited (40 each with and without AKI). Severity of cirrhosis and platelet count were comparable between groups. Median serum creatinine was 1.8 mg/dL and 0.8 mg/dL in patients with and without AKI, respectively. At baseline, patients with cirrhosis and AKI had lower platelet aggregation and secretion, indicative of impaired platelet function (increased bleeding tendency), without differences in VWF. Reg...Continue Reading

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Mentioned in this Paper

Cell Secretion
Antithrombins
Post Abortion Haemorrhage
Protein S Deficiency
Thrombophilia
Protein Targeting
Coagulants
Generic Drugs
Thrombosis
Serum Creatinine Level

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