Haemostasis in chronic kidney disease

Lutz, Jens; Menke, Julia; Sollinger, Daniel; Schinzel, H.; Thürmel, Klaus

doi:10.1093/ndt/gft209

Cited by 350 publications

(324 citation statements)

References 99 publications

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“…Finally, patients with cirrhosis are at risk of developing both acute and chronic kidney disease [83][84][85][86][87]. In the general population, chronic renal disease is associated with a high thrombotic risk, while in acute renal failure the bleeding risk prevails over that of thrombosis.…”

Section: Factors Tipping the Hemostatic Balance In Cirrhosismentioning

confidence: 99%

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Andriulli

Tripodi

Angeli

et al. 2016

Digestive and Liver Disease

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a b s t r a c tPatients with cirrhosis present with hemostatic alterations secondary to reduced availability of procoagulant and anti-coagulant factors. The net effect of these changes is a rebalanced hemostatic system. The Italian Association of the Study of the Liver (AISF) and the Italian Society of Internal Medicine (SIMI) promoted a consensus conference on the hemostatic balance in patients with cirrhosis. The consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Rome in December 2014. The statements were graded according to quality of evidence and strength of recommendations, and approved by an independent jury. The statements presented here highlight strengths and weaknesses of current laboratory tests to assess bleeding and thrombotic risk in cirrhotic patients, the pathophysiology of hemostatic perturbations in this condition, and outline the optimal management of bleeding and thrombosis in patients with liver cirrhosis.

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Section: Factors Tipping the Hemostatic Balance In Cirrhosismentioning

confidence: 99%

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Andriulli

Tripodi

Angeli

et al. 2016

Digestive and Liver Disease

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“…Unfortunately, the benefits of correcting coagulopathies before transplantation is challenging because renal failure patients are prone to both bleeding disorders and hypercoagulability. 20 There is limited information regarding the reasons why some patients develop bleeding problems, while others develop excessive thrombus formation. 20 Bleeding disorders can result from the insufficient function of platelets, the coagulation cascade, or the activation of the fibrinolytic system.…”

Section: Discussionmentioning

confidence: 99%

“…20 There is limited information regarding the reasons why some patients develop bleeding problems, while others develop excessive thrombus formation. 20 Bleeding disorders can result from the insufficient function of platelets, the coagulation cascade, or the activation of the fibrinolytic system. [20][21][22] In contrast, hypercoagulability can result from platelet hyperactivity or disorders of coagulation regulatory factors.…”

Section: Discussionmentioning

confidence: 99%

“…20 Bleeding disorders can result from the insufficient function of platelets, the coagulation cascade, or the activation of the fibrinolytic system. [20][21][22] In contrast, hypercoagulability can result from platelet hyperactivity or disorders of coagulation regulatory factors. [20][21][22] With kidney transplant recipients easily tipped towards bleeding or thrombotic complications, the goals and indications for correcting coagulation factors before or during kidney transplantation needs to be defined.…”

Section: Discussionmentioning

confidence: 99%

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A nationwide analysis of re-operation after kidney transplant

Moghadamyeghaneh

Chen

Alameddine

et al. 2017

CUAJ

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Introduction: We aimed to report the rate and short-term outcomes of patients undergoing reoperation following kidney transplant in the U.S. Methods: The ationwide Inpatient Sample (NIS) database was used to examine the clinical data of patients undergoing kidney transplant and reoperation during same the hospitalization from 2002-2012. Multivariate regression analysis was performed to compare outcomes of patients with and without re-operation. Results: We sampled a total of 35 058 patients who underwent kidney transplant. Of these, 770 (2.2%) had re-operation during the same hospitalization. Re-operation was associated with a significant increase in mortality (30.4% vs. 3%; adjusted odds ratio [AOR] 4.62; p<0.01), mean total hospital charges ($249 425 vs. $145 403; p<0.01), and mean hospitalization length of patients (18 vs. 7 days, p<0.01). The most common day of re-operation was POD 1. Hemorrhagic complication (64.2%) was the most common reason for re-operation, followed by urinary tract complications (9.9%) and vascular complications (3.6%). Preoperative coagulopathy (AOR 3.35; p<0.01) was the strongest predictor of need for re-operation, hemorrhagic complications (AOR 3.08; p<0.01), and vascular complications (AOR 2.50; p<0.01). Also, hypertension (AOR 1.26; p<0.01) and peripheral vascular disorders (AOR 1.25; p=0.03) had associations with hemorrhagic complications. Conclusions: Re-operation after kidney transplant most commonly occurs on postoperative Day 1 and occurs in 2.2% of cases. It is associated with significantly increased mortality, hospitalization length, and total hospital charges. Hemorrhage is the most common complication.

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“…One reason is a higher rate of therapy with anticoagulants, in addition to pathologic clotting, which has been linked to uremia itself (1). Samples from these patients with ESRD require long periods of time to clot completely.…”

Section: Introductionmentioning

confidence: 99%

Chemistry Testing on Plasma Versus Serum Samples in Dialysis Patients: Clinical and Quality Improvement Implications

Carey¹,

Jani

Johnson

et al. 2016

CJASN

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Plasma samples collected in tubes containing separator gels have replaced serum samples for most chemistry tests in many hospital and commercial laboratories. Use of plasma samples for blood tests in the dialysis population eliminates delays in sample processing while waiting for clotting to complete, laboratory technical issues associated with fibrin formation, repeat sample collection, and patient care issues caused by delay of results because of incompletely clotted specimens. Additionally, a larger volume of plasma is produced than serum for the same amount of blood collected. Plasma samples are also acceptable for most chemical tests involved in the care of patients with ESRD. This information becomes very important when United States regulatory requirements for ESRD inadvertently limit the type of sample that can be used for government reporting, quality assessment, and value-based payment initiatives. In this narrative, we summarize the renal community experience and how the subsequent resolution of the acceptability of phosphorus levels measured from serum and plasma samples may have significant implications in the country's continued development of a value-based Medicare ESRD Quality Incentive Program.

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Haemostasis in chronic kidney disease

Cited by 350 publications

References 99 publications

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

A nationwide analysis of re-operation after kidney transplant

Chemistry Testing on Plasma Versus Serum Samples in Dialysis Patients: Clinical and Quality Improvement Implications

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