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

Abdelmaguid, Alyaa; Roberts, Lara N.; Tugores, Laura; Joslin, Jennifer; Hunt, Beverley J.; Parmar, Kiran; Nebres, Danilo; Naga, Salah S.; Khalil, Eman; Bramham, Kate

doi:10.1111/jth.15653

Cited by 20 publications

(11 citation statements)

References 51 publications

(89 reference statements)

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“…Under catecholamine stimulation, adenosine suppresses AV nodal conduction by directly activating adenosine-sensitive potassium channels, while it suppresses AV automaticity by indirectly antagonizing beta-adrenergic mediated increase in pacemaker current (I f ) and calcium current (I ca ). [6][7][8] The conversion of NPJT to sinus rhythm without AV nodal block by adenosine and beta blocker is consistent with the catecholamineenhanced automatic mechanism in the present case.…”

Section: Discussionsupporting

confidence: 89%

Non-paroxysmal junctional tachycardia complicating disseminated intravascular coagulation during massive surgical hemorrhage: A case report

Chun,

Jung

2024

Medicine

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Rationale: Non-paroxysmal junctional tachycardia (NPJT) is a self-limiting supraventricular tachycardia associated with primary heart disease, cardiac surgery, digitalis toxicity, and metabolic or electrolyte imbalances. However, NPJT caused enhanced normal automaticity even in the absence of structural heart disease can be fatal if not managed properly. Patient concerns: A 74-year-old hypertensive female patient was scheduled for transureteroureterostomy and right ureteroneocystostomy under general anesthesia. Diagnosis: The patient developed NPJT without visible P wave and severe hypotension due to adrenergic stimulation in response to massive hemorrhage during surgery. Interventions: NPJT with hypotension was initially converted to sinus rhythm with normotension with administration of adenosine and esmolol. However uncontrolled surgical hemorrhage and administration of large dose of vasopressors eventually perpetuated NPJT refractory to antiarrhythmic drugs. Outcomes: Despite intravenous fluid resuscitation and massive transfusion, the patient was deteriorated hemodynamically due to uncontrolled bleeding and persistent NPJT, which resulted in hypovolemic shock and fatal disseminated intravascular coagulation (DIC). Lessons: NPJT can occur by enhanced automaticity due to increased catecholamine during severe surgical hemorrhage. Although NPJT is generally self-limiting, it can be refractory to antiarrhythmic agents and accelerate hypotension if the surgical bleeding is uncontrolled. Therefore, aggressive management of the primary pathologic condition is crucial for the management of NPJT and hemodynamic collapse even in the absence of structural heart disease.

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Section: Discussionsupporting

confidence: 89%

Non-paroxysmal junctional tachycardia complicating disseminated intravascular coagulation during massive surgical hemorrhage: A case report

Chun,

Jung

2024

Medicine

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“…We read Abdelmaguid et al's elegant description of coagulation markers in different stages of chronic kidney disease (CKD) from their experienced hemostasis group with interest. 1 As anticipated, thrombelastometry parameters are hypercoagulable, which supports prior findings with various visco-elastic monitors. [2][3][4] As there are potential clinical implications for these findings, especially in perioperative situations with associated hemorrhagic and thrombotic risk, we hoped to see additional discrete information from Abdelmaguid et al's study.…”

Section: 'Evaluation Of Novel Coagulation and Platelet Function Assay...supporting

confidence: 84%

‘Evaluation of novel coagulation and platelet function assays in patients with chronic kidney disease’: Comment

Pivalizza¹,

Pivalizza

2022

Journal of Thrombosis and Haemostasis

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“…Prothrombin fragment analyses, thrombin-antithrombin III complex, and d-dimer evaluation can assess the "pre-clotting" stages, as well as platelet-to-lymphocyte ratio, obtained by dividing the absolute platelet count by the absolute lymphocyte count, which could represent a novel marker of inflammation in HD patients [30][31][32].…”

Section: Platelets and Coagulation Systemmentioning

confidence: 99%

Immune System Dysfunction and Inflammation in Hemodialysis Patients: Two Sides of the Same Coin

Campo

Lacquaniti

Trombetta

et al. 2022

JCM

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Biocompatibility in hemodialysis (HD) has considerably improved in recent decades, but remains an open issue to be solved, appearing essential to reduce systemic inflammation and enhance patients’ clinical outcomes. Clotting prevention, reduction in complement and leukocyte activation, and improvement of antioxidant effect represent the main goals. This review aims to analyze the different pathways involved in HD patients, leading to immune system dysfunction and inflammation. In particular, we mostly review the evidence about thrombogenicity, which probably represents the most important characteristic of bio-incompatibility. Platelet activation is one of the first steps occurring in HD patients, determining several events causing chronic sub-clinical inflammation and immune dysfunction involvement. Moreover, oxidative stress processes, resulting from a loss of balance between pro-oxidant factors and antioxidant mechanisms, have been described, highlighting the link with inflammation. We updated both innate and acquired immune system dysfunctions and their close link with uremic toxins occurring in HD patients, with several consequences leading to increased mortality. The elucidation of the role of immune dysfunction and inflammation in HD patients would enhance not only the understanding of disease physiopathology, but also has the potential to provide new insights into the development of therapeutic strategies.

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

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 20 publications

References 51 publications

Non-paroxysmal junctional tachycardia complicating disseminated intravascular coagulation during massive surgical hemorrhage: A case report

Non-paroxysmal junctional tachycardia complicating disseminated intravascular coagulation during massive surgical hemorrhage: A case report

‘Evaluation of novel coagulation and platelet function assays in patients with chronic kidney disease’: Comment

Immune System Dysfunction and Inflammation in Hemodialysis Patients: Two Sides of the Same Coin

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