Evaluation of hemostasis in patients with end-stage renal disease

PloS One
Anja GäcklerFuat H Saner

Abstract

An increased bleeding risk is reported for patients with end-stage renal disease. This study aims to analyze, whether bleeding risk can be assessed by global tests of hemostasis. Standard laboratory tests and an extended evaluation of hemostasis by rotational thromboelastometry, platelet function analyzer (PFA) and multiple electrode aggregometry as well as thrombin generation assays and measurement of fibrinolytic potential were performed in 20 patients on hemodialysis, 10 patients on peritoneal dialysis, 10 patients with chronic kidney disease stage G5 (CKD5) and in 10 healthy controls (HC). Hemoglobin was significantly lower in patients with end-stage renal disease versus HC (each p<0.01). Patients on peritoneal dialysis showed increased fibrinogen levels compared to HC (p<0.01), which were also reflected by FIBTEM results (each p<0.05). 41% of hemodialysis patients and 44% of CKD5 patients presented with prolonged PFA-ADP-test (p<0.05), while no patient on peritoneal dialysis and no HC offered this modification. Thrombin generating potential was significantly lower in patients on hemodialysis, while clot lysis time revealed a hypofibrinolytic state in patients on hemo- and peritoneal dialysis compared to HC (p<0.001). In co...Continue Reading

References

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Citations

Aug 2, 2019·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Bharath Chelluboina, Raghu Vemuganti
Aug 6, 2020·Journal of Clinical Medicine·Paweł T MatusikAnetta Undas
Jul 3, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Alberto ZanettoGuadalupe Garcia-Tsao
May 5, 2021·Journal of the American Society of Nephrology : JASN·Constance C F M J BaatenHeidi Noels
Jun 19, 2021·Journal of the American Society of Nephrology : JASN·Nishank JainJohn Arthur
Nov 10, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Constance C F M J BaatenHeidi Noels
Jan 25, 2022·Journal of Thrombosis and Haemostasis : JTH·Alyaa AbdelmaguidKate Bramham

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Methods Mentioned

BETA
blood drawing
biopsies

Software Mentioned

ASPItest
FIBTEM
RISTOlowtest
RISTOlow
INTEM
Thrombinoscope

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