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Abstract: SA-PO591

Duration of Hemodialysis as an Amplifier of Thrombolytic Deficit and Oxidative Stress in ESRD

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Nikolovski, Srdjan, Loyola University Medical Center, Maywood, Illinois, United States
  • Siddiqui, Fakiha, Loyola University Medical Center, Maywood, Illinois, United States
  • Reddy, Bhavana, Loyola University Medical Center, Maywood, Illinois, United States
  • Hoppensteadt, Debra, Loyola University Medical Center, Maywood, Illinois, United States
  • Kantarcioglu, Bulent, Loyola University Medical Center, Maywood, Illinois, United States
  • Allen, Madeline T., Loyola University Medical Center, Maywood, Illinois, United States
  • Krupa, Emily G., Loyola University Medical Center, Maywood, Illinois, United States
  • Fareed, Jawed, Loyola University Medical Center, Maywood, Illinois, United States
  • Bansal, Vinod K., Loyola University Medical Center Department of Nephrology, Maywood, Illinois, United States
Background

Thrombo-inflammation and oxidative stress increase as kidney function declines. Additionally, the incidence of thromboembolic events is several times higher in patients with end-stage renal disease (ESRD) on hemodialysis (HD). However, the mechanism underlying the increased risk for thrombotic events has not yet been thoroughly investigated. The aim of this study is to measure the level of biomarkers of thrombo-inflammation and oxidative stress in ESRD patients on HD and to investigate the association of those levels with HD duration.

Methods

In this cross-sectional study, levels of oxidative stress-related, and thrombo-inflammatory biomarkers, as well as blood cell count values were determined in plasma samples of ESRD patients undergoing HD at a single healthcare center. Time between sample collection date and the initiation of HD was correlated with the measured biomarker levels. Commercially available normal human plasma samples were used as a healthy control group.

Results

The study included 96 patients with median age of 64 years (interquartile range-IQR 50-74), and 40 healthy control plasma samples. The median time since initiation of HD in ESRD group was 62 months (IQR 25-94). The levels of tissue-type plasminogen activator (tPA) and functional plasminogen activator inhibitor 1 (PAI-1) were significantly higher in ESRD patients, compared to control group (Med 4.2 vs 0.4 ng/mL and Med 7.0 vs 3.2 IU/mL, respectively). Significant positive correlation of tPA and functional PAI-1 levels was observed with the time spent on HD in months (r=0.32, p=0.03 and r=0.35, p=0.02, respectively). Those biomarkers were entered into age-adjusted logistic regression model showing predictive potential of HD duration on functional PAI-1 levels only (OR 0.32, p=0.03) (Table 1).

Conclusion

Increase of functional PAI-1 during the time spent on HD clearly suggests that the risk of developing thrombotic complications may rise over time due to the increase of fibrinolytic deficit which is modulated by an upregulation of functional PAI-1 in ESRD patients on HD.