Relationship between pre- and post-thrombosis factors in patients with stage VD CKD treated by long-term hemodialysis

Abstract

The aim: To determine informative value of pre-thrombosis, post-thrombosis and anticoagulation factors as well as their correlations for assessment of hemostasis status in patients with stage VD CKD. Materials and methods: Potential predictors of thrombophilia development as well as their relationships depending on the level of molecular markers of hemostasis were studied in 88 patients with stage VD CKD undergoing long-term hemodialysis with the view to determine their informative value. Results: Accumulation of soluble fibrin (sF) was demonstrated to cause moderate reaction of D-dimer (D-d) being insufficient in the absence of reaction of anticoagulant component of hemostasis. Soluble fibrin levels were found to be associated with D-d concentration (r = 0.39) and functionally inactive prothrombin forms (FIPF) to some extent (r = -0.24). Accumulation of FIPF in individuals with high level of sF implies significant activation of blood coagulation system at the stage prior to thrombin formation. Absence of close relationship between pre- and post-thrombosis indices may be indicative of still preserved potential of anticoagulant component of hemostasis. Conclusions: Accumulation of FIPF is an early marker of activation of blood coagulation and possible thrombosis. Levels of sF correlate with pre-thrombosis (fibrinogen, FIPF) and post-thrombosis (D-d) factors being associated with inhibition of anticoagulation processes. Comprehensive study of basic components of hemostasis in patients with VD stage of chronic kidney disease offer broader opportunities in arranging prophylactic measures to prevent thrombophilia.