End Stage Renal Disease, Coagulopathy
Conditions
Keywords
End stage renal disease, ESRD, Thromboelastography, Fibrinogen
Brief summary
Background: Coagulopathy in chronic kidney disease is multifactorial. Both hypocoagulopathy and hypercoaguability are seen. Conventional tests of coagulation (CCTs) end at the formation of thrombin, and do not take into account the interaction of coagulation factors, platelets, RBC etc. By overcoming the above deficiencies, thromboelastography provides a holistic picture of blood coagulation. The present study evaluated the TEG profile of ESRD patients and compared it to CCTs and to controls. Methods: 50 ESRD patients and 50 controls were recruited for the study. Venous samples were withdrawn and platelet count, INR and fibrinogen levels were measured. Simultaneously a Thromboelastography was performed. All samples were drawn prior to initiation of dialysis.
Interventions
DEVICEThromboelastography
A viscoelastic test of coagulation
Sponsors
Institute of Liver and Biliary Sciences, India
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Healthy voluntary donors belonging to ASA PSI or ASA PSII 2. Patients suffering from end stage renal disease i.e. CKD stage 5 (Defined by KDIGO 2012 ) who never received renal replacement therapy (RRT)
Exclusion criteria
1. Patients on antiplatelet drugs, erythropoietin, desmopressin 2. Patients with known bleeding disorders like haemophilia, aplastic anaemia etc 3. Patients having coexisting liver diseases 4. Patients on dialysis 5. Patients who have received PRBC, FFPs or Platelet Transfusions in the past 3 months 6. Patients less than 18 years of age 7. Pregnant patients 8. Malignancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To compare the maximum amplitude on a thromboelastography in patients of chronic kidney disease stage 5 with normal controls. | 0 hr | Maximum amplitude in whole blood will be measures by a standard kaolin thromboelastography in all patients and controls. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To correlate the maximum amplitude with platelet count and fibrinogen levels in patients of chronic kidney disease | 0 hr | the maximum amplitude obtained on an thromboelastography denotes clot strength which depends on platelet count and fibrinogen levels. thus an attempt will be made to corelate these values with fibrinogen levels and platelet count. |
Outcome results
None listed