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Haemostatic profiles assessed by thromboelastography in patients with end-stage renal disease.
MedLine Citation:
PMID:  21655674     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Patients with end-stage renal disease (ESRD) have abnormalities in the cellular and plasmatic systems regulating blood homeostasis, which may contribute to their risk for thrombotic and bleeding complications. However, their relative contributions in this population are poorly understood. The aim of this study was to evaluate the distribution of enzymatic and cellular abnormalities in ESRD patients on haemodialysis as assessed by thromboelastography (TEG®). Whole blood samples were analysed by TEG in ESRD patients (n=70) and in a control group (n=70) of subjects with coronary artery disease. Profiles were constructed considering the maximum amplitude (MA), a marker of platelet function, and reaction time (R), a marker of thrombin generation, values. R values were higher in ESRD patients compared with the control group (8.2 ± 2.8 vs. 5.7 ± 1.9 minutes [min], p <0.0001), while there were no differences in MA (66.7 ± 8.1 vs. 66.2 ± 6.6 mm, p=0.562). Normal manufacturer defined coagulation (2-8 min) and aggregation (51-69 mm) parameters were present in 31% of ESRD patients compared with 56% of controls (p=0.006). A hypocoagulable status was observed in 42.9% of ESRD patients compared with 8.9% in the control group (p<0.0001). There were no differences in platelet function, which showed a hyperaggregable status in 41.4% versus 35.7% of cases (p=0.603). Abnormalities in both parameters were observed in 15.7% of ESRD patients versus 1.4% in the control group (p= 0.004), which were more common among older patients (p= 0.005). In conclusion, patients with ESRD have an elevated prevalence of abnormal haemostatic profiles, which may contribute to their elevated risk of bleeding and thrombotic complications.
Authors:
A Darlington; J L Ferreiro; M Ueno; Y Suzuki; B Desai; P Capranzano; D Capodanno; A Tello-Montoliu; T A Bass; N S Nahman; D J Angiolillo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-09
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  106     ISSN:  0340-6245     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Dominick J. Angiolillo MD, PhD, University of Florida College of Medicine-Jacksonville, 655 West 8th Street, Jacksonville, Florida, 32209, USA, Tel: +1 904 244 3933, Fax: +1 904 244 3102, E-mail: dominick.angiolillo@jax.ufl.edu.
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