Coagulopathy associated with Hepato-renal disorders and its significance in critically ill patients

Abstract

Coagulopathy has a high prevalence among critically ill patients and is the result of the derangement of both procoagulant and anticoagulant components of the coagulation system. Liver and renal function tests are some of the most commonly performed blood tests which assess the liver and kidney injury and these are one of the commonest causes of deranged coagulation parameters in these patients. This prospective observational study was conducted for two years in Department of Pathology in a tertiary care hospital in university medical college in western India. 219 cases with underlying liver and renal disorders were included in this study. Complete blood counts and coagulation studies including Prothrombin time (PT), Activated Partial Thromboplastin time (APTT), Fibrinogen were done. Statistical analysis was done to evaluate the correlation between various parameters. In our study, hepatic encephalopathy was the commonest cause followed by alcoholic liver disease and liver cirrhosis. Chronic kidney disease was common cause in patients with renal disorders. Deranged Bilirubin levels had a significant statistical association with PT while APTT had a significant association with blood urea levels. Advanced diagnostic and laboratory methods, early recognition of the signs and symptoms of coagulopathy and the complicating factors in liver and renal disorders in these patients is possible today. Liver and renal disorders are one of the important underlying causes for development of coagulopathies in criticially ill patients. Prompt and correct identification of these disorders and associated coagulopathy is important for proper management and improving outcome in these patients.