The state of hemostasis in patients with CKD VD stage with some comorbid conditions

Abstract

Annotation. Clinical observations indicate that one of the rather important mechanisms in the pathogenesis of complications in CKD stage VD are disorders in the hemostatic system leading to the development of thrombophilia. Comorbidity in this category of patients significantly worsens the prognosis due to the potentiation of hypercoagulation, which, as a comorbid syndrome, accelerates morphological changes in the kidneys, contributes to the deposition of fibrin in the glomeruli and the development of thrombosis. The aim of the study was to study the indices of the main links of hemostasis depending on some comorbid conditions (acute inflammation, secondary hyperparathyroidism, hepatitis B and C). The study involved 52 men and 36 women with CKD stage VD, who were on programmed hemodialysis, in whom the levels of soluble fibrin, D-dimer, fibrinogen, protein C, indicators of hemostatic potential in these comorbid conditions were determined. Statistical processing of materials was performed using the methods of variation statistics.It was determined that the presence of a fast phase of inflammation enhances the processes of hypercoagulability, and a high level of parathyroid hormone (˃800 pg/ml) in combination with hyperphosphoremia slightly increases the level of fibrinogen. Infection with hepatitis C significantly increases the level of soluble fibrin, and infection with hepatitis B decreases the level of protein C. The study and implementation of a comprehensive assessment of the state of hemostasis in patients with CKD stage VD complicated by comorbid diseases makes it possible to identify imbalances in the pro- and anticoagulation system.

Артеріовенозна Фістула Для Гемодіалізу: Сучасні Рекомендації Та Стратегії Догляду

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