Haemostatic profiles assessed by thromboelastography in patients with end-stage renal disease

Andrew Darlington, José Luis Ferreiro, Masafumi Ueno, Yoshi Suzuki, Bhaloo Desai, Piera Capranzano, Davide Capodanno, Antonio Tello-Montoliu, Theodore A. Bass, Norris S. Nahman, Dominick J. Angiolillo

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Patients with end-stage renal disease (ESRD) have abnormalities in the cellular and plasmatic systems regulating blood homeostasis, which may contribute to their risk for thrombotic and bleeding complications. However, their relative contributions in this population are poorly understood. The aim of this study was to evaluate the distribution of enzymatic and cellular abnormalities in ESRD patients on haemodialysis as assessed by thromboelastography (TEG→). Whole blood samples were analysed by TEG in ESRD patients (n=70) and in a control group (n=70) of subjects with coronary artery disease. Profiles were constructed considering the maximum amplitude (MA), a marker of platelet function, and reaction time (R), a marker of thrombin generation, values. R values were higher in ESRD patients compared with the control group (8.2 ± 2.8 vs. 5.7 ± 1.9 minutes [min], p <0.0001), while there were no differences in MA (66.7 ± 8.1 vs. 66.2 ± 6.6 mm, p=0.562). Nor-mal manufacturer defined coagulation (2-8 min) and aggregation (51-69 mm) parameters were present in 31% of ESRD patients compared with 56% of controls (p=0.006). A hypocoagulable status was observed in 42.9% of ESRD patients compared with 8.9% in the control group (p<0.0001). There were no differences in platelet function, which showed a hyperaggregable status in 41.4% versus 35.7% of cases (p=0.603). Abnormalities in both parameters were observed in 15.7% of ESRD patients versus 1.4% in the control group (p= 0.004), which were more common among older patients (p= 0.005). In conclusion, patients with ESRD have an elevated prevalence of abnormal haemostatic profiles, which may contribute to their elevated risk of bleeding and thrombotic complications.

Original languageEnglish (US)
Pages (from-to)67-74
Number of pages8
JournalThrombosis and Haemostasis
Volume106
Issue number1
DOIs
StatePublished - Jul 1 2011

Fingerprint

Thrombelastography
Hemostatics
Chronic Kidney Failure
Control Groups
Blood Platelets
Hemorrhage
Thrombin
Reaction Time
Renal Dialysis
Coronary Artery Disease
Homeostasis

Keywords

  • Coagulation
  • End stage renal disease
  • Platelet function

ASJC Scopus subject areas

  • Hematology

Cite this

Darlington, A., Ferreiro, J. L., Ueno, M., Suzuki, Y., Desai, B., Capranzano, P., ... Angiolillo, D. J. (2011). Haemostatic profiles assessed by thromboelastography in patients with end-stage renal disease. Thrombosis and Haemostasis, 106(1), 67-74. https://doi.org/10.1160/TH10-12-0785

Haemostatic profiles assessed by thromboelastography in patients with end-stage renal disease. / Darlington, Andrew; Ferreiro, José Luis; Ueno, Masafumi; Suzuki, Yoshi; Desai, Bhaloo; Capranzano, Piera; Capodanno, Davide; Tello-Montoliu, Antonio; Bass, Theodore A.; Nahman, Norris S.; Angiolillo, Dominick J.

In: Thrombosis and Haemostasis, Vol. 106, No. 1, 01.07.2011, p. 67-74.

Research output: Contribution to journalArticle

Darlington, A, Ferreiro, JL, Ueno, M, Suzuki, Y, Desai, B, Capranzano, P, Capodanno, D, Tello-Montoliu, A, Bass, TA, Nahman, NS & Angiolillo, DJ 2011, 'Haemostatic profiles assessed by thromboelastography in patients with end-stage renal disease', Thrombosis and Haemostasis, vol. 106, no. 1, pp. 67-74. https://doi.org/10.1160/TH10-12-0785
Darlington, Andrew ; Ferreiro, José Luis ; Ueno, Masafumi ; Suzuki, Yoshi ; Desai, Bhaloo ; Capranzano, Piera ; Capodanno, Davide ; Tello-Montoliu, Antonio ; Bass, Theodore A. ; Nahman, Norris S. ; Angiolillo, Dominick J. / Haemostatic profiles assessed by thromboelastography in patients with end-stage renal disease. In: Thrombosis and Haemostasis. 2011 ; Vol. 106, No. 1. pp. 67-74.
@article{9f9180e2b2004af8a5e9acd1f90e2bd7,
title = "Haemostatic profiles assessed by thromboelastography in patients with end-stage renal disease",
abstract = "Patients with end-stage renal disease (ESRD) have abnormalities in the cellular and plasmatic systems regulating blood homeostasis, which may contribute to their risk for thrombotic and bleeding complications. However, their relative contributions in this population are poorly understood. The aim of this study was to evaluate the distribution of enzymatic and cellular abnormalities in ESRD patients on haemodialysis as assessed by thromboelastography (TEG→). Whole blood samples were analysed by TEG in ESRD patients (n=70) and in a control group (n=70) of subjects with coronary artery disease. Profiles were constructed considering the maximum amplitude (MA), a marker of platelet function, and reaction time (R), a marker of thrombin generation, values. R values were higher in ESRD patients compared with the control group (8.2 ± 2.8 vs. 5.7 ± 1.9 minutes [min], p <0.0001), while there were no differences in MA (66.7 ± 8.1 vs. 66.2 ± 6.6 mm, p=0.562). Nor-mal manufacturer defined coagulation (2-8 min) and aggregation (51-69 mm) parameters were present in 31{\%} of ESRD patients compared with 56{\%} of controls (p=0.006). A hypocoagulable status was observed in 42.9{\%} of ESRD patients compared with 8.9{\%} in the control group (p<0.0001). There were no differences in platelet function, which showed a hyperaggregable status in 41.4{\%} versus 35.7{\%} of cases (p=0.603). Abnormalities in both parameters were observed in 15.7{\%} of ESRD patients versus 1.4{\%} in the control group (p= 0.004), which were more common among older patients (p= 0.005). In conclusion, patients with ESRD have an elevated prevalence of abnormal haemostatic profiles, which may contribute to their elevated risk of bleeding and thrombotic complications.",
keywords = "Coagulation, End stage renal disease, Platelet function",
author = "Andrew Darlington and Ferreiro, {Jos{\'e} Luis} and Masafumi Ueno and Yoshi Suzuki and Bhaloo Desai and Piera Capranzano and Davide Capodanno and Antonio Tello-Montoliu and Bass, {Theodore A.} and Nahman, {Norris S.} and Angiolillo, {Dominick J.}",
year = "2011",
month = "7",
day = "1",
doi = "10.1160/TH10-12-0785",
language = "English (US)",
volume = "106",
pages = "67--74",
journal = "Thrombosis and Haemostasis",
issn = "0340-6245",
publisher = "Schattauer GmbH",
number = "1",

}

TY - JOUR

T1 - Haemostatic profiles assessed by thromboelastography in patients with end-stage renal disease

AU - Darlington, Andrew

AU - Ferreiro, José Luis

AU - Ueno, Masafumi

AU - Suzuki, Yoshi

AU - Desai, Bhaloo

AU - Capranzano, Piera

AU - Capodanno, Davide

AU - Tello-Montoliu, Antonio

AU - Bass, Theodore A.

AU - Nahman, Norris S.

AU - Angiolillo, Dominick J.

PY - 2011/7/1

Y1 - 2011/7/1

N2 - Patients with end-stage renal disease (ESRD) have abnormalities in the cellular and plasmatic systems regulating blood homeostasis, which may contribute to their risk for thrombotic and bleeding complications. However, their relative contributions in this population are poorly understood. The aim of this study was to evaluate the distribution of enzymatic and cellular abnormalities in ESRD patients on haemodialysis as assessed by thromboelastography (TEG→). Whole blood samples were analysed by TEG in ESRD patients (n=70) and in a control group (n=70) of subjects with coronary artery disease. Profiles were constructed considering the maximum amplitude (MA), a marker of platelet function, and reaction time (R), a marker of thrombin generation, values. R values were higher in ESRD patients compared with the control group (8.2 ± 2.8 vs. 5.7 ± 1.9 minutes [min], p <0.0001), while there were no differences in MA (66.7 ± 8.1 vs. 66.2 ± 6.6 mm, p=0.562). Nor-mal manufacturer defined coagulation (2-8 min) and aggregation (51-69 mm) parameters were present in 31% of ESRD patients compared with 56% of controls (p=0.006). A hypocoagulable status was observed in 42.9% of ESRD patients compared with 8.9% in the control group (p<0.0001). There were no differences in platelet function, which showed a hyperaggregable status in 41.4% versus 35.7% of cases (p=0.603). Abnormalities in both parameters were observed in 15.7% of ESRD patients versus 1.4% in the control group (p= 0.004), which were more common among older patients (p= 0.005). In conclusion, patients with ESRD have an elevated prevalence of abnormal haemostatic profiles, which may contribute to their elevated risk of bleeding and thrombotic complications.

AB - Patients with end-stage renal disease (ESRD) have abnormalities in the cellular and plasmatic systems regulating blood homeostasis, which may contribute to their risk for thrombotic and bleeding complications. However, their relative contributions in this population are poorly understood. The aim of this study was to evaluate the distribution of enzymatic and cellular abnormalities in ESRD patients on haemodialysis as assessed by thromboelastography (TEG→). Whole blood samples were analysed by TEG in ESRD patients (n=70) and in a control group (n=70) of subjects with coronary artery disease. Profiles were constructed considering the maximum amplitude (MA), a marker of platelet function, and reaction time (R), a marker of thrombin generation, values. R values were higher in ESRD patients compared with the control group (8.2 ± 2.8 vs. 5.7 ± 1.9 minutes [min], p <0.0001), while there were no differences in MA (66.7 ± 8.1 vs. 66.2 ± 6.6 mm, p=0.562). Nor-mal manufacturer defined coagulation (2-8 min) and aggregation (51-69 mm) parameters were present in 31% of ESRD patients compared with 56% of controls (p=0.006). A hypocoagulable status was observed in 42.9% of ESRD patients compared with 8.9% in the control group (p<0.0001). There were no differences in platelet function, which showed a hyperaggregable status in 41.4% versus 35.7% of cases (p=0.603). Abnormalities in both parameters were observed in 15.7% of ESRD patients versus 1.4% in the control group (p= 0.004), which were more common among older patients (p= 0.005). In conclusion, patients with ESRD have an elevated prevalence of abnormal haemostatic profiles, which may contribute to their elevated risk of bleeding and thrombotic complications.

KW - Coagulation

KW - End stage renal disease

KW - Platelet function

UR - http://www.scopus.com/inward/record.url?scp=79960037921&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960037921&partnerID=8YFLogxK

U2 - 10.1160/TH10-12-0785

DO - 10.1160/TH10-12-0785

M3 - Article

C2 - 21655674

AN - SCOPUS:79960037921

VL - 106

SP - 67

EP - 74

JO - Thrombosis and Haemostasis

JF - Thrombosis and Haemostasis

SN - 0340-6245

IS - 1

ER -