Predictors of thrombogenesis by the state of pro and anticoagulant components of hemostasis in the patients with stage VD chronic kidney disease

Abstract

One of the major complications of stage V chronic kidney disease (CKD), treated by program hemodialysis, are hemostatic system disturbances resulting in thrombosis development. To detect early predictors of potential thrombosis in study category of patients is rather difficult because of inflammatory process, accumulation of antibodies, continuous damage of blood elements. The aim: To estimate potential applicability of activators and inhibitors of thrombogenesis as thrombophilia markers in the patients with stage V CKD, treated by program hemodialysis. Materials and methods: 88 patients (52 males and 36 females) with stage V CKD, treated by program hemodialysis, were studied. Hemostatic profile was estimated in all the patients (soluble fibrin, D-dimer, protein C, fibrinogen). Results: Two thirds of the patients with stage V CKD, treated by program hemodialysis, had significant increase in soluble fibrin and fibrinogen concentration against the background of decrease of natural anticoagulant – protein C and disparate response of D-dimer (tendency to decrease). It was established that comprehensive estimation of activators and inhibitors of thrombogenesis can become an indicator of thrombophilias in the patients with stage V CKD, treated by long term hemodialysis. Conclusions: The majority of patients (68.2%) with stage VD CKD, treated by long term hemodialysis, had significant increase of soluble fibrin level along with decreased D-dimer to borderline values. In general group of patients there was significant decrease of protein C on the background of great increase of fibrinogen concentration in the majority of patients (62%). The females were found to have significant increase of D-dimer level along with the increase of soluble fibrin concentration. Comprehensive determination of activators and inhibitors of thrombogenesis can serve an indicator of thrombophilias in the patients with stage VD CKD, treated by program hemodialysis.