Features of hemostasis disorders in patients with CKD VD stage and their relationship with the course of the disease
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.
 Dohlback, B., & Villoutreix, B. O. (2005). Regulation of blood coagulation by the protein C anticoagulant pathway: Novel Insights Into Structure-Function Relationships and Molecular Recognition. Arterioscler. Thromb. Vasc. Biol., 25(7), 1311-1320. doi: 10.1161/01.ATV.0000168421.13467.82
 Gubensek, J., Lolic, M., Ponikvar, R., & Buturovic-Ponikvar, J. (2016). D-dimer levels in maintenance hemodialysis patients: High prevalence of positive values also in the group without predisposing diseases. Hemodial Int., 20(2), 198-203. doi: 10.1111/hdi.12371
 Ichinose, M., Sasagawa, N., Chiba, T., Toyama, K., Kayamori, Y., & Kang, D. (2019). Protein C and protein S deficiencies may be related to survival among hemodialysis patients. BMC Nephrol., 20(1), 191. doi: 10.1186/s12882-019-1344-8
 Komisarenko, S. V. (2017). Research of molecular mechanisms of thrombosis and creation of hemostatic agents. Visn. Nac. Acad. Nauk Ukr., 3, 38-44. ISSN 1027-3239
 Lugovskoy, E. V., Gritsenko, N. G., Lugovskaya, N. E., Kolesnikova, I. N., & Komisarenko, S. V. (2006). Soluble fibrin. Molecular structure and quantification. Laboratory diagnostics, 3(37), 11-17.
 Lugovskoy, E. V., Kolesnikova, I. N., Lugovskaya, N. E., Gritsenko, P. G., Litvinova, L. M., Gogolinskaia, G. K., … & Komisarenko, S. V. (2006). Soluble fibrin and D-dimer at normal pregnancy and pregnancy with risk miscarriage. Ukr. Biochem. Zhurn., 78(4), 120-129. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17236629/
 Lugovskoy, E. V., Komisarenko, S. V., Platonova, T. M., Rublenko, A. M., Fishchenko, V. O., & Kolesnikova, I. M. (2013). Determination of soluble fibrin and D-dimer content for prediction of thrombotic complications by hip arthroplasty. Laboratory diagnostics, 2(64), 3-8. Retrieved from http://nbuv.gov.ua/UJRN/labdiag_2013_2_2
 Meamar, R., Shafiei, M., Abedini, A., Ghazvini, M. R., Roomizadeh, P., Taheri, S. & Gheissari, A. (2016). Association of E-selectin with hematological, hormonal levels and plasma proteins in children with end stage renal disease. Adv. Biomed. Res., 29(5), 118. doi: 10.4103/2277-9175.186992
 Melnik, A. A. (2016). The hemostatic system and its regulation in case of impaired renal function. News of medicine and pharmacy in Ukraine, 9(583), 24-31. doi: 10.22141/2307-1218.104.22.1686.76541
 Milburn, J. A., Ford, I., Mutch, N., Fluck, N., & Brittenden, J. (2013). Thrombin-Anti-Thrombin Levels and Patency of Arterio-Venous Fistula in Patients Undergoing Haemodialysis Compared to Healthy Volunteers: A Prospective Analysis PLoS One, 8(7), e67799. doi: 10.1371
 Muslimovic, A., Rasic, S., Tulumovic, D., Hasanspahic, S., & Rebic, D. (2015). Inflammatory Markers and Procoagulants in Chronic Renal Disease Stages 1-4. Med. Arch., 69(5), 307-310. doi: 10.5455/medarh.2015.69.307-310
 Nunns, G. R., Moore, E. E., Chapman, M. P., Moore, H. B., Stettler, G. R., Peltz, E., … & Sauaia, A. (2017). The hypercoagulability paradox of chronic kidney disease: The role of fibrinogen. Am. J. Surg., 214(6), 1215-1218. doi: 10.1016/j.amjsurg.2017.08.039
 Platonova, T. N., Zaichko, N. V., Chernyshenko, T. M., Gornitskaya, O. V., & Grischuk, V. I. (2010). Assessment of the informative value and prognostic value of traditional screening and additional laboratory tests for the diagnosis of thrombophilia. Laboratory diagnostics, 4(54), 3-10.
 Popova, J. A., Yadrihinskaya, V. N., Krylova, M. I., Sleptsovа, S. S., & Borisovа, N. V. (2016). Comparison of clinical and laboratory parameters in patients with end-stage renal failure in the outcome of chronic glomerulonephritis and patients with end-stage renal failure in the outcome of other diseases. Wiad Lek., 69(6), 739-741. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28214807/
 Shevchuk, S. V., Gornytska, O. V., Chernyshenko, T. M., Krasnobryzha, E. M., Korolyova, D. S., Chernyshenko, V. O., & Platonova, T. M. (2010). Comprehensive diagnosis of thrombophilia in systemic lupus erythematosus. Laboratory diagnostics, 1(51), 3-7. Retrieved from https://biocherv.ucoz.com/publ/
 Storozhuk, L. O., Shevchuk, S. V., Storozhuk, B. G., Zaichko, N. V., Lugovskoy, E. V., Platonova, T. M., ... & Storozhuk, N. V. (2017). Clinical and laboratory diagnosis of thrombophilia in patients with XXH VD stage on program hemodialysis: guidelines. Vinnytsia: FOP Rogalska I.O. Retrieved from https://dspace.vnmu.edu.ua/123456789/2933
 Storozhuk, O. B., Seleznyova, I. B., Storozhuk, L. O., Storozhuk, B. G., & Dovgalyuk, T. V. (2018). Predictors of thrombogenesis by the state of pro- and anticoagulant components of haemostasis in the patients with stage VD chronic kidney disease. Wiad Lekarsk., 71(3), cz II, 683-687. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29783247/
 Storozhuk, O. B., Seleznyova, I. B., Storozhuk, L. O., Gornitskaya, O. V., Storozhuk, B. G., & Slominsky, A. Yu. (2017). Functionally inactive forms of prothrombin and fibrinogen levels as markers of hypercoagulation in patients with chronic stage VD kidney disease who are on programmed hemodialysis. Reports of Vinnytsia National Medical University, 21(2), 450-53. Retrieved from http://nbuv.gov.ua/UJRN/vvnmu_2017_21_2_20
 Volkov, G. L., Platonova, T. N., Savchuk, A. M., Gornitskaya, O. V., Chernyshenko, T. M., & Krasnobryzha, E. M. (2005). Modern ideas about the hemostatic system. Kiev: Scientific thought.
This work is licensed under a Creative Commons Attribution 4.0 International License.