Abstract: PO2266
Persistent Coagulation Abnormalities in ESRD After 1 Year of Follow-Up
Session Information
- Pathology and Lab Medicine: Clinical
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Pathology and Lab Medicine
- 1602 Pathology and Lab Medicine: Clinical
Authors
- Bontekoe, Emily, Loyola University Medical Center, Maywood, Illinois, United States
- Bansal, Vinod K., Loyola University Medical Center, Maywood, Illinois, United States
- Siddiqui, Fakiha, Loyola University Medical Center, Maywood, Illinois, United States
- Hoppensteadt, Debra, Loyola University Medical Center, Maywood, Illinois, United States
- Fareed, Jawed, Loyola University Medical Center, Maywood, Illinois, United States
Background
Common to end-stage renal disease (ESRD), coagulation abnormalities can lead to severe bleeding events or excessive thrombi formation and engender increased morbidity and mortality in this population. Repeated heparin administration to ESRD patients during maintenance hemodialysis may also contribute to changes in the coagulation system. Thus, profiling coagulation parameters in ESRD patients over 1-year may provide insight to long-term coagulation dysfunction in this population.
Methods
Blood samples were collected at baseline and 1-year from ESRD patients undergoing maintenance hemodialysis (n=95) 48-hours post-dialysis. Plasma samples were analyzed using clot-based methods including activated partial thromboplastin time (aPTT), prothrombin time (PT), and thrombin time (TT). Chromogenic assays measured heparin levels by anti-Xa and anti-IIa methods. Patients were categorized by heparin administration during dialysis (n=44) and compared via statistical method and percent change.
Results
In the clotting and chromogenic assays, all parameters were elevated in the baseline and 1-year ESRD cohorts compared to controls, as shown on Figure 1. Only anti-IIa levels demonstrated a significant difference in ESRD patients after 1-year (p<0.0001). Heparin administration varied in aPTT, TT, and anti-Xa (p<0.05).
Conclusion
These results suggest ESRD patients on dialysis exhibit a long-term, hypo-coagulable state as shown by prolonged aPTT and TT. Elevated parameters maintained over 1-year suggests persistent dysregulation of clotting factors in ESRD patients. Circulating levels of heparin, as evidenced by anti-Xa and anti-IIa assays may be due to impaired clearance of heparin components via dialysis.