Comparative characteristics of hemostasis system in patients with end-stage renal disease admitted for urgent and elective hemodialysis
- Authors: Kotlyarova G.V.1, Kozlovskaya N.L.1, Lashutin S.V.1, Komyagin Y.V.1, Shakhnova E.A.1, Dobrosmyslov I.A.1, Shilov E.M.1, Nesterova S.G.1, Kotlyarova GV2, Kozlovskaya NL2, Lashutin SV3, Komyagin Y.V3, Shakhnova EA2, Dobrosmyslov IA2, Shilov EM2, Nesterova SG2
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Affiliations:
- I.M. Sechenov First Moscow State Medical University, Moscow
- S.P. Botkin State Hospital, Moscow
- Issue: Vol 83, No 6 (2011)
- Pages: 36-41
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/30859
- ID: 30859
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Full Text
Abstract
Material and methods. A total of 47 patients with ESRD entered the study. They were divided into two groups depending on urgent (group 1) or elective (group 2) start of hemodialysis. Group 1 consisted of 31 patients (13 female, 18 male) aged 18-86 years, group 2 - of 16 patients (9 female, 7 male) aged 36-79 years. The patients were comparable by ESRD causes. Clinical and laboratory findings were compared: activated partial thromboplastin time, prothrombin time, levels of fibrinogen, soluble complexes fibrin-monomers (SCFM).
Results. Azotemia, hyperkalemia and anemia were close to similar. Group 1 patients had more severe alterations of nutrition status and fat metabolism, marked hyperhydration and hypervolemia, arterial hypertension, more frequent neurological and infectious complications, symptoms of enteritis. Thrombotic complications developed in 51.5%, thromboses of the vascular access in 45% in group 1 vs group 2 which demonstrated only one type of thrombotic complications - thromboses of primary arteriovenous fistula (in 1 patient, 6.25%). Hemorrhagic complications were absent in group 2, in group 1 these developed 5 times less frequently than thromboses. Platelet count was significantly less (p = 0.001) in group 1 than in group 2. Hyperfibrinogenemia occurred in about 65% patients of group 1 and in 46% in group 2. SCFM levels were elevated in both groups, but in group 1 these levels were by 50% higher than in group 2 (p = 0.005). This evidences for stronger activation of intravascular coagulation in patients on urgent hemodialysis.
Conclusion. ESRD patients admitted for urgent hemodialysis had more severe uremic syndrome with stronger activation of blood coagulation than patients admitted for elective hemodialysis. Frequency of thrombosis in patients admitted for urgent hemodialysis was 8.3 times higher than in patients admitted for elective hemodialysis.
About the authors
Galina Vladimirovna Kotlyarova
Email: galopa@yandex.ru
Natal'ya L'vovna Kozlovskaya
Email: nkozlovskaya@yandex.ru
Sergey Vital'evich Lashutin
Email: hd13@yandex.ru
Yuriy Viktorovich Komyagin
Elena Alekseevna Shakhnova
Igor' Aleksandrovich Dobrosmyslov
Evgeniy Mikhaylovich Shilov
Svetlana Georgievna Nesterova
G V Kotlyarova
I.M. Sechenov First Moscow State Medical University, MoscowI.M. Sechenov First Moscow State Medical University, Moscow
N L Kozlovskaya
I.M. Sechenov First Moscow State Medical University, MoscowI.M. Sechenov First Moscow State Medical University, Moscow
S V Lashutin
S.P. Botkin State Hospital, MoscowS.P. Botkin State Hospital, Moscow
Yu V Komyagin
S.P. Botkin State Hospital, MoscowS.P. Botkin State Hospital, Moscow
E A Shakhnova
I.M. Sechenov First Moscow State Medical University, MoscowI.M. Sechenov First Moscow State Medical University, Moscow
I A Dobrosmyslov
I.M. Sechenov First Moscow State Medical University, MoscowI.M. Sechenov First Moscow State Medical University, Moscow
E M Shilov
I.M. Sechenov First Moscow State Medical University, MoscowI.M. Sechenov First Moscow State Medical University, Moscow
S G Nesterova
I.M. Sechenov First Moscow State Medical University, MoscowI.M. Sechenov First Moscow State Medical University, Moscow
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