Thrombelastography of blood from subjects with chronic renal failure

Holloway, Debra; Vagher, J P; Caprini, Joseph A.; Simon, Norman; Mockros, Lyle F.

doi:10.1016/0049-3848(87)90091-0

Cited by 38 publications

(19 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12, 17, 18 Additionally, the findings of a delayed clot formation, decreased lysis and increased fibrinogen levels have been seen in some prior studies. 12, 17, 18 The delayed clot formation seen may predispose to bleeding complications. Furthermore, the increased clot strength and decreased breakdown in this group may account for the increased thrombotic complications in this group.…”

Section: Discussionmentioning

confidence: 77%

“…Given the known platelet dysfunction in CKD, increased fibrinogen appears to be responsible for the observed hypercoagulability as a compensatory mechanism to normalize hemostasis in the presence of platelet dysfunction. 2, 12, 13 Elevated fibrinogen levels have been shown to correlate with myocardial complications in patients with Stage 5 CKD. 19 This supports the theory that hyperfibrinogenemia and associated increased clot strength as assessed by increased MA, is mechanistic in the physiologic coagulopathy and the complications with thrombosis in CKD patients clinically.…”

Section: Discussionmentioning

confidence: 99%

“…10, 11 CKD has been associated with both platelet dysfunction as well as hyperfibrinogenemia. 2, 5, 12 Thrombocytopenia has been successfully compensated for by the addition of fibrinogen concentrate. 13 Additionally, fibrinogen concentrates have been used clinically used in European centers for the treatment of traumatic coagulopathy.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The hypercoagulability paradox of chronic kidney disease: The role of fibrinogen

Nunns

Moore

Chapman

et al. 2017

The American Journal of Surgery

View full text Add to dashboard Cite

Background Chronic kidney disease (CKD) patients have increased rates of bleeding as well as thrombosis. Fibrinogen and platelets combine to generate a mature clot, but in CKD platelets are dysfunctional. Therefore, we hypothesize that CKD patients have increased clot strength due to elevated fibrinogen levels. Methods Retrospective review of CKD patients (n=84) who had rTEG and fibrinogen levels measured. They were compared to healthy controls (n=134). Results CKD patients had statistically significant increases in ACT, angle, MA and decreases in LY30 compared to controls. Fibrinogen levels were increased in CKD patients compared to reference range. Fibrinogen levels had a positive correlation with MA (rho = 0.709, p<0.0001) in CKD patients. Conclusions Patients with CKD manifest a coagulopathy consisting of delayed clot formation, but increased final clot strength and decreased clot breakdown. Furthermore, the elevated clot strength is mediated by increased fibrinogen levels in CKD patients.

show abstract

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The hypercoagulability paradox of chronic kidney disease: The role of fibrinogen

Nunns

Moore

Chapman

et al. 2017

The American Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Postoperative hypercoagulability, detected by TEG, has been reported in patients undergoing hepatic surgery [14], general abdominal procedures [15,16], and neurosurgery [17]. Other clinical settings associated with hypercoagulability detected by TEG include ischemic heart disease [18], end-stage renal failure [19], insertion of cutdown intravenous catheters [20], exposure to oral contraceptives [21], or non-ionic contrast media [22]. Thromboelastographic analysis of hypercoagulability has been also performed in patients with malignancies in the earlier literature using first the native whole blood TEG and then the celite-activated TEG [11,23,24].…”

Section: Discussionmentioning

confidence: 98%

Laboratory investigation of hypercoagulability in cancer patients using rotation thrombelastography

et al. 2008

View full text Add to dashboard Cite

The goal of this study was laboratory testing for hypercoagulability in patients with solid tumors using rotation thrombelastogram (ROTEM) and correlate ROTEM parameters with routine coagulation tests. A total of 78 untreated patients with cancer were included: 28 gastrointestinal system tumors (group 1), 27 respiratory system tumors (group 2), and 23 miscellaneus group of ovarian, renal, nasopharyngeal, mesothelioma, and unknown origin (group 3). Platelet count was significantly increased in group 2 in respect to group 3 (P < 0.05) and fibrinogen level was significantly increased in group 2 in respect to group 1 (P < 0.05). There was no statistically significant difference between subgroups in respect to TEG parameters. Tumor-node-metastasis (TNM) stages of patients was not also associated with either of TEG parameters. Correlation analysis revealed significant correlation between laboratory parameters and ROTEM parameters. Fibrinogen showed the strongest correlation with MCF (r > 0.7) and CFT in all assays (INTEM, EXTEM, FIBTEM, APTEM). There were also statistically significant correlations between platelet number and other ROTEM parameters (INTEM-CFT, -MCF, EXTEM-CFT, -MCF, FIBTEM-MCF, APTEM-CFT, -MCF). In conclusions, our data demonstrates thromboelastographic signs of hypercoagulability in patients with solid tumors. ROTEM is able to identify the contribution of fibrinogen and platelets to clot strength in this patient population.

show abstract

“…Collet et al [16] reported that unfavourable clot properties can also be detected in patients with nephrotic syndrome. Whole blood thromboelastography in patients with renal failure showed an increased clot rigidity and accelerated clot formation accompanied by hypofibrinolysis [17]. Very recently, Sjoland et al [18] described marked alterations in fibrin clot properties evaluated in 22 patients on chronic peritoneal dialysis compared with healthy volunteers.…”

Section: Introductionmentioning

confidence: 99%

Altered fibrin clot properties in patients on long-term haemodialysis: relation to cardiovascular mortality

Undas

Kolarz²,

Kopeć

et al. 2008

Nephrology Dialysis Transplantation

View full text Add to dashboard Cite

Background. Haemodialysis patients are at an increased risk of cardiovascular (CV) morbidity and mortality. Both end-stage renal disease (ESRD) and thromboembolic coronary events have been shown to be associated with the formation of dense fibrin clots resistant to fibrinolysis. The aim of the present study was to investigate the effect of longterm haemodialysis on clot structure/function and analyse an influence of markers of inflammation, oxidative stress and lipoprotein(a). We sought also to investigate if clot features might be related to CV events and mortality in haemodialysis patients. Subjects and methods. In 33 patients (19 males, 14 females), aged 27 to 89 years, on long-term haemodialysis and 33 age-and sex-matched apparently healthy controls, we investigated fibrin clot properties and susceptibility to lysis using recombinant tissue plasminogen activator by using permeation and turbidity assays. Results. Haemodialysis patients produced fibrin clots that had less porous structure (P < 0.0001) were less susceptible to fibrinolysis (P < 0.0001), began fibrin protofibril formation more quickly (P < 0.0001) and showed increased overall fibre thickness (P < 0.0001) compared with controls. Clot permeability and lysis time correlated with F2-isoprostanes (P < 0.01), Lp(a) (P < 0.0001) and fibrinogen (P < 0.01). None of the clot variables showed associations with the duration of haemodialysis treatment or the cause of ESRD. During a 36-month follow-up, 10 CV deaths were recorded. Mortality was associated with reduced clot permeability (P < 0.0001), prolonged lysis time (P < 0.0001), faster fibrin protofibril formation (P = 0.0004), thicker fibres (P < 0.0001) and increased fibrin clot mass (P < 0.0001). Conclusions. Unfavourably altered clot properties can be detected in haemodialysis patients and may be associated with increased CV mortality.

show abstract

Thrombelastography of blood from subjects with chronic renal failure

Cited by 38 publications

References 13 publications

The hypercoagulability paradox of chronic kidney disease: The role of fibrinogen

The hypercoagulability paradox of chronic kidney disease: The role of fibrinogen

Laboratory investigation of hypercoagulability in cancer patients using rotation thrombelastography

Altered fibrin clot properties in patients on long-term haemodialysis: relation to cardiovascular mortality

Contact Info

Product

Resources

About