Abstract: TH-PO0863
Dysregulation of Fibrinolytic Process in ESRD: A Functional Assessment Using Plasma Lysis Slope
Session Information
- Dialysis: Prescription, Physiology, and Treatment Optimization
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Vellanki, Anuha, Loyola University Medical Center, Maywood, Illinois, United States
- Kempaiah, Prakasha, Loyola University Medical Center, Maywood, Illinois, United States
- Siddiqui, Fakiha, Loyola University Medical Center, Maywood, Illinois, United States
- Jeske, Walter, Loyola University Medical Center, Maywood, Illinois, United States
- Hoppensteadt, Debra, Loyola University Medical Center, Maywood, Illinois, United States
- Walenga, Jeanine, 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, Maywood, Illinois, United States
Background
End-stage renal disease (ESRD) is associated with significant hemostatic dysregulation, contributing to thrombotic and bleeding complications. Fibrinolysis plays a critical role in clot resolution and impairment of this process can lead to delayed clot breakdown and increased thrombotic risk. Functional assessment of fibrinolysis in ESRD remains limited.
Methods
Plasma samples from ESRD patients (n = 62) and blood bank plasma controls (BBP, n = 10) were analyzed using plasma lysis assay. Plasma lysis time assay was performed using Lysis Timer (Hyphen BioMed). Lysis slope was measured as an indicator of fibrinolytic activity. Samples were stratified based on lysis slope, with values <40 min defined as hypofibrinolytic and >70 min as hyperfibrinolytic. Plasma PAI-1 antigen levels were measured and compared to normal healthy plasma (NHP) reference values to evaluate associations between fibrinolytic inhibition and clot lysis parameters. Data were expressed as mean (SD).
Results
ESRD samples showed a mean lysis slope of 46.6 ± 30.4 min, comparable to BBP controls (44.8 ± 34.5 min) but with high variability. Stratification identified hypofibrinolysis in 40.3% (n=25) and hyperfibrinolysis in 29.0% (n=18) of patients. Mean PAI-1 levels were elevated in ESRD versus NHP references (26.9 ± 18.7 vs. 18.4 ± 10.2 ng/mL). Elevated PAI-1 levels correlated with reduced lysis slopes and prolonged lysis times, confirming that increased inhibition drives the hypofibrinolytic phenotype in a substantial subset of ESRD patients.
Conclusion
ESRD demonstrates a highly heterogeneous fibrinolytic profile, with hypofibrinolytic and hyperfibrinolytic phenotypes present. These findings highlight the complexity of fibrinolytic dysregulation in ESRD and underscore the importance of functional assays in characterizing patient-specific hemostatic profiles.