Annotation. Violations in the hemostatic system of patients with chronic kidney disease (CKD) of the VD stage treated with program hemodialysis are associated with a high thrombotic risk. Comprehensive studies of the possible causes and predictors of thrombophilia can improve the therapeutic and prophylactic measures to combat thrombotic complications. The search for available methods for predicting these complications is very relevant. The goal is to develop a method for predicting the development of thrombotic complications in this category of patients, which would allow identifying the degree of hemostasis disorders. We examined 88 patients with CKD VD, treated with program hemodialysis, who determined the fibrinolytic potential and the level of soluble fibrin and D-dimer by enzyme immunoassay. It is proposed to use the developed fibrinolytic coefficient (Fc) to predict thrombotic complications. It was found that the proposed method for assessing hemostasis using Fc makes it possible to objectively characterize the state of the coagulation link and can serve as an indicator of thrombotic risk.
The aim: To determine informative value of pre-thrombosis, post-thrombosis and anticoagulation factors as well as their correlations for assessment of hemostasis status in patients with stage VD CKD.
Materials and methods: Potential predictors of thrombophilia development as well as their relationships depending on the level of molecular markers of hemostasis were
studied in 88 patients with stage VD CKD undergoing long-term hemodialysis with the view to determine their informative value.
Results: Accumulation of soluble fibrin (sF) was demonstrated to cause moderate reaction of D-dimer (D-d) being insufficient in the absence of reaction of anticoagulant
component of hemostasis. Soluble fibrin levels were found to be associated with D-d concentration (r = 0.39) and functionally inactive prothrombin forms (FIPF) to some extent (r = -0.24). Accumulation of FIPF in individuals with high level of sF implies significant activation of blood coagulation system at the stage prior to thrombin formation. Absence of close relationship between pre- and post-thrombosis indices may be indicative of still preserved potential of anticoagulant component of hemostasis.
Conclusions: Accumulation of FIPF is an early marker of activation of blood coagulation and possible thrombosis. Levels of sF correlate with pre-thrombosis (fibrinogen, FIPF)
and post-thrombosis (D-d) factors being associated with inhibition of anticoagulation processes. Comprehensive study of basic components of hemostasis in patients with VD stage of chronic kidney disease offer broader opportunities in arranging prophylactic measures to prevent thrombophilia.
Thrombotic complications, associated with hemostatic system disturbances in patients with stage VD chronic kidney disease (CKD), occur rather frequently. Hence, the search of early available biological markers in diagnosis of this complication is of great significance. Objective – to study coagulation potential of blood plasma in patients with stage VD CKD, treated by program hemodialysis, and to determine the markers of thrombotic risk. 88 patients (aged 26–65) with stage VD CKD, treated by program hemodialysis, were studied. Hemostatic potential of blood was determined by spectrophotometry; soluble fibrin level — by two-site enzyme-linked immune-sorbent quantitative assay; D-dimer — by enzyme immunoassay using monoclonal antibodies to D-dimer epitopes; protein C activity — by spectrophotometry with wavelength 405 nm; fibrinogen contents — by spectrophotometry with wavelength 280 nm. Statistical processing was performed by methods of variation statistics and correlation analysis. All patients were found to have significant increase of soluble fibrin level (4.03±0.15÷4.62±0.31 mg/ml) (р <0.001), but there was a group of patients (n=25), who demonstrated increased coagulation potential, (р <0.001), significantly prolonged fibrinolysis (р <0.001) and increased soluble fibrin concentration (5.36±0.61÷5.78±0.82 µg/ml) (р <0.001) along with the tendency to decreased C protein level and no response of D-dimer to increased soluble fibrin level. Detected changes in coagulation properties of blood plasma can serve the markers of thrombotic risk. Thus, the patients with stage VD CKD, treated by program hemodialysis, have high risk of thrombosis, associated with high concentration of soluble fibrin and fibrinogen. But in this category of patients, rather low fibrinolytic potential, as well as the level of natural anticoagulant — C protein — is observed. The studied homeostatic parameters can be used as the markers of thrombotic risk.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.