Relation between Endothelial Protein C Receptor Gene Polymorphism 6936A/G and the Risk of Vascular Access Thrombosis in Patients with End Stage Renal Disease on Hemodialysis

Abstract

Background:The most significant complication of chronic kidney disease (CKD) is end-stage renal disease (ESRD). Hemodialysis (HD) necessitates a well-functioning vascular access with enough blood flow for clearance and blood dialysis. Thrombosis of the veins can be caused by both acquired and inherited factors. Aim of The Work: To to assess EPCR levels in patients with ESRD on hemodialysis & study relationship between the presence of EPCR gene polymorphisms (6936A/G) and incidence of vascular access thrombosis. Patients and Methods: This research was carried out on 50 studied cases admitted to the Theodor Bilharz Research Institute (TBRI), Imbaba, Giza, Hemodialysis Unit, Nephrology Department from November 2018 to May 2019. In addition, 25 age and sex-matched normal people (control cases) were included. Results: The mutant EPCR (6936A/G) genotypes were found to be substantially more prevalent in our investigation and the polymorphic type allele (G allele) in (p < 0.05) in ESRD patients on long-term hemodialysis with thrombosis compared to healthy subjects and ESRD patients without thrombosis. the flow cytometric expression of CD 201 was statistically reduced in ESRD patients on long-term hemodialysis with thrombosis (p < 00.01) & without thrombosis (p < 00.05) when compared to healthy subjects. CD201 Expression levels showed negative correlation with EPCR 6936 A/G heteromutant genotype. Conclusion: The result obtained via the recurrent study provide evidence that EPCR 6936A/G (rs867186) genetic polymorphisms in ESRD patients on long-term hemodialysis could be a potential reason for Venous thrombosis.