ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO2266

Persistent Coagulation Abnormalities in ESRD After 1 Year of Follow-Up

Session Information

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.