Hyperhomocysteinemia, anticardiolipin antibody status, and risk for vascular access thrombosis in hemodialysis patients

Manns, Braden; Burgess, Ellen; Parsons, Howard G.; Schaefer, Jeffrey P.; Hyndman, M. Eric; Scott-Douglas, Nairne

doi:10.1046/j.1523-1755.1999.00258.x

Cited by 62 publications

(36 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Besides, there are reports suggesting no relationship between ACA positivity and thrombosis in relation to a selected patient population (12,38). In our study, anti-cardiolipin antibody (Ig G and Ig M) levels detected in patients with or without thrombus formation were similar before and after fistula operation; thereby, it was shown that these factors were not effective in thrombus formation.…”

Section: Discussioncontrasting

confidence: 37%

Evaluation of Risk Factors for Arteriovenous Fistula Failure in Patients Undergoing Hemodialysis

Sarı¹,

Taşkapan²,

Sigirci³

et al. 2016

Erciyes Med J

View full text Add to dashboard Cite

Objective: The aim of the present study is to evaluate the relationship between demographic characteristics, hematological and biochemical parameters, and elements of the coagulation system that may predispose a person to thrombosis or to anatomical and functional parameters in Doppler ultrasonography scanning and the maturation and adequacy of arteriovenous fistulas. Materials and Methods:Overall, 36 patients who underwent a native arteriovenous fistula operation were included. Biochemical parameters, hematological parameters, the coagulation system, and a Doppler ultrasonography evaluation were performed before an arteriovenous fistula operation on day 1 after the fistula operation and at the time point when the arteriovenous fistula became dysfunctional.Results: A thrombus occurred between 1 and 73 days (mean: 28.4±26.1) in 10 patients. It was found that the female gender (p<0.001), presence of thrill (p=0.014), quality of vein (p<0.001), peak systolic velocity and end-diastolic velocity of the radial artery at the snuffbox region on day 1 after the operation (p=0.035 and p=0.049, respectively), and the cephalic vein diameter in the Brescia-Cimino region (p=0.011) were associated with thrombosis formation. No relation was found among blood pressure, fistula region, quality of artery, spasm of artery and vein, hematologic and biochemical parameters, coagulation parameters, active protein C resistance, anti-cardiolipin antibody, D-dimer, C-reactive protein, or erythrocyte sedimentation rate and thrombosis formation (p>0.05).Conclusion: Thrombosis occurs at a relatively early period in approximately a quarter of arteriovenous fistulas. Female gender, quality of vein, and the absence of thrill in the post-operative period are important factors in thrombosis formation.

show abstract

Section: Discussioncontrasting

confidence: 37%

Evaluation of Risk Factors for Arteriovenous Fistula Failure in Patients Undergoing Hemodialysis

Sarı¹,

Taşkapan²,

Sigirci³

et al. 2016

Erciyes Med J

View full text Add to dashboard Cite

show abstract

“…classification ( Figure 2C (13,15). In these settings, isolated and lowtiter aCL appeared not to be associated with an increased risk of thrombosis before (25) or after renal transplantation (15 …”

Section: Aps Is the Most Common Cause Of Acquired Thrombophilia And Cmentioning

confidence: 92%

Severe Vascular Lesions and Poor Functional Outcome in Kidney Transplant Recipients with Lupus Anticoagulant Antibodies

Canaud

Bienaimé

Nôël

et al. 2010

American Journal of Transplantation

View full text Add to dashboard Cite

The impact of antiphospholipid antibodies (APA) on clinical outcome and graft histology following renal transplantation remains poorly known and controversial. We retrospectively explored the functional and histological significance of APA, primarily lupus anticoagulant (LA), in kidney transplant recipients using a systematic evaluation of 3-and 12-month posttransplant screening biopsies and glomerular filtration rate measurements (mGFR). During the study period, 37 patients had APA (2.7%), primarily LA, and 12 fulfiled antiphospholipid syndrome (APS) diagnostic criteria (0.8%) at the time of transplantation. Early after transplantion, 4 of the 12 APS patients died. Early thrombosis of graft vessels and deep venous thrombosis occurred more frequently in APA+ patients than in controls (27% vs. 7%, p < 0.05 and 35% vs. 14%, p < 0.05, respectively). The survival rate was significantly lower in patients with APS. Strikingly, the hallmark lesions of APS-associated nephropathy (APSN) were found in most of screening graft biopsies in APA+ patients but not in the controls. Accordingly, APA+ patients had a dramatic increase in chronic vascular scores and a faster decline in mGFR at 1 year. In conclusion, renal transplantation may be life-threatening in APS patients, and the presence of LA at the time of transplantation is associated with a high rate of allograft APSN and poor transplantation outcomes.

show abstract

“…Studies on inherited or acquired thrombophilia in access thrombosis are scarce among patients with ESRD, and the results are contradictory. This is due to limited patient numbers, retrospective thrombophilia screening, and differences in definition and inclusion of individual types of thrombophilia (4)(5)(6)(7)(8)(9)(10)(11). One large retrospective study of 419 patients undergoing HD found at least one thrombophilic disorder in 43% of patients with ESRD, and any thrombophilic disorder increased the risk for access thrombosis (2).…”

Section: Introductionmentioning

confidence: 99%

Thrombophilia and Arteriovenous Fistula Survival in ESRD

Salmela

Hartman²,

Peltonen³

et al. 2013

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives The role of thrombophilia in failing arteriovenous fistula (AVF) among patients with ESRD undergoing hemodialysis is not established. This study aimed to assess whether AVF primary patency is associated with thrombophilia and coagulation abnormalities.Design, setting, participants, & measurements This observational study screened 219 patients between 2002 and 2004 for thrombophilia before AVF surgery. Thrombophilia included factor V Leiden and prothrombin G20210A mutations, protein C and antithrombin activities, and protein S. Coagulation abnormalities included high factor VIII:C, homocysteine, fibrinogen, and D-dimer levels; presence of antiphospholipid antibodies; and short thrombin time. We reviewed patient charts for comorbid conditions, AVF maturation and interventions, kidney transplantation, and patient survival (mean follow-up duration, 3.6 [range, 2.3-5.8] years). Primary patency from the AVF placement and functional primary patency from the first AVF cannulation were analyzed with Kaplan-Meier and Cox proportional hazards models.Results Thrombophilia was present in 9% of the patients, and coagulation abnormalities occurred in 77%. One-year primary patency was 68%; 46% of the AVF failures occurred before the initiation of hemodialysis. Female sex (hazard ratio [HR], 2.6; 95% confidence interval [CI], 1.7-4.1) and thrombophilia (HR, 2.2; 95% CI, 1.2-4.2) were independent risk factors for loss of primary patency. Thrombophilia mutations or low antithrombin level (HR, 3.8), female sex (HR, 2.5), and diabetes (HR, 1.9) were associated with shortened functional primary patency of AVF.Conclusions Against the background of frequent coagulation abnormalities, thrombophilia and female sex predispose patients with ESRD to access failure, mostly due to thrombosis or stenosis.

show abstract

Hyperhomocysteinemia, anticardiolipin antibody status, and risk for vascular access thrombosis in hemodialysis patients

Abstract: No association was found between homocysteine levels or anticardiolipin antibody and vascular access thrombosis in our patient population.

Cited by 62 publications

References 24 publications

Evaluation of Risk Factors for Arteriovenous Fistula Failure in Patients Undergoing Hemodialysis

Evaluation of Risk Factors for Arteriovenous Fistula Failure in Patients Undergoing Hemodialysis

Severe Vascular Lesions and Poor Functional Outcome in Kidney Transplant Recipients with Lupus Anticoagulant Antibodies

Thrombophilia and Arteriovenous Fistula Survival in ESRD

Contact Info

Product

Resources

About