Does Hypercoagulability Exist in CAPD Patients?

Abstract

Blood levels of fibrinogen degradation products (FDP), factor VIII (antigen and coagulant), plasminogen and antithrombin III, as well as fibrinogen half-life were studied in 15 patients on CAPD from 3–24 months; the daily loss of these factors in the dialysate was also determined. Fibrinogen and factor VIII levels were above (p < 0.05), fibrinogen half-life was below (p < 0.05) and AT III was within the normal range. The average daily protein loss in the dialysate was 7.74: t 2.42 g; fibrinogen loss was 48.14:t 41.66 mg;FDP241.37 :t 185.19 mg; plasminogen 11.16 :t 6.94, and AT IIl64.96 :t 37.67 mg. These findings suggest that patients on CAPD have a state of hypercoagulability similar to that observed in patients with the nephrotic syndrome. Continuous ambulatory peritoneal dialysis (CAPD) is accompanied by protein losses, which may lead to protein depletion (1). The situation is similar in the nephrotic syndrome (NS), which, in addition, has the features of a hypercoagulability state (2, 3). After observing the appearance of thrombotic events in some CAPD patients, we set out to determine whether patients undergoing continuous ambulatory peritoneal dialysis also have a hypercoagulability state and this paper presents our findings.