Abstract
Disorders in the hemostatic system leading to the development of thrombosis are one of the main complications in patients with chronic kidney disease (CKD) of stage VD who are on program hemodialysis. The development of thrombophilic syndrome as a process of intravascular coagulation is characterized by systemic activation of procoagulative mechanisms, which are not always compensated by internal natural anticoagulant systems. The determination of early predictors of possible thrombogenesis in the studied category of patients causes significant difficulties. The goal is to study the features of hemostatic system disorders in patients with CKD VD stage who are on programmed hemodialysis, and to assess their relationship with the characteristics of the course of the disease. In 88 patients with CKD of the VD stage who are on program hemodialysis (52 men and 36 women), the features of hemostasis disorders depending on the clinical characteristics of the patients were studied. The indicators of prethrombosis (soluble fibrin (sF), fibrinogen (Fg), functionally inactive forms of prothrombin (FIFP)), postthrombosis (D-dimer (D-d)) and anticoagulation (protein C (pC)) were determined depending on gender, hemodialysis experience, age, the presence of anemia, arterial hypertension (AH) and preserved residual renal function (RRF). Statistical processing of materials was carried out using methods of variation statistics using t-student criterion. It was found that violations in the hemostatic system are detected in almost all patients. At the same time, hyperfibrinogenemia, an increase in sF concentration, a deficiency of pC, less often an accumulation of FIFP and high levels of D-d are most often observed. These disorders of hemostasis are more often found in patients with absent RRF, a longer experience of hemodialysis, the presence of arterial hypertension and are less associated with gender, age of patients and are little dependent on the degree of anemia.
Highlights
Disorders in the hemostasis system, which lead to the development of thrombosis, are one of the main complications of patients with chronic kidney disease (CKD) stage VD, who are on program hemodialysis [10]
It was found that in patients with CKD stage VD with a high (95.5 %) frequency, disorders in the hemostasis system were registered, which was characterized by increased levels of fibrinogen, soluble fibrin, D-dimer, accumulation of functionally inactive forms of prothrombin (FIFP) and decreased protein C
The average level of fibrinogen in the studied patients was 89.0 % higher compared to the control, and the share of persons with hyperfibrinogenemia was more than 13 times higher
Summary
Disorders in the hemostasis system, which lead to the development of thrombosis, are one of the main complications of patients with chronic kidney disease (CKD) stage VD, who are on program hemodialysis [10]. Determining the early predictors of possible thrombogenesis in the studied category of patients causes significant difficulties. The latter is related, inter alia, to the individual clinical characteristics of patients. In the process of clot formation and cleavage, the two most important molecular markers for assessing the state of hemostasis are soluble fibrin (sF) and D-dimer (Dd) [7, 18]. In this case, it is necessary to consider the potential of a natural blood
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