Buradasınız

Hemodiyaliz Hastalarında Hemostatik Sistemin Arteriyovenöz Fistül Trombozu Yönünden İncelenmesi

Evaluatıon of Hemostatic System in Patients with Arteriovenous Fistula Thrombosis on Hemodialysis

Journal Name:

Publication Year:

Abstract (2. Language): 
Hemodialysis patients have a tendency toward to thrombosis. AVF thrombosis is frequent in those patients. Study was aimed to evaluate patients by means of hemostatic state at our study, hemostatic parameters in haemodialysis patients with respect to healthy group were evaluated. Haemodialysis group (HDG) consisted of 45 patients (27 male, 18 female) and control group (CG) consisted of 15 healthy persons (8 male, 7 female). These parameters were evaluated whether contributing to thrombosis APC resistance is found to be higher in patient group. AT III and tPA antigen levels are low in patient group, while vWF antigen levels are high in patients with AVF problem compared to healthy subjects. Hypofibrinolysis and prethrombotic state were thought to play role in contributing vascular endothelial injury and AVF thrombosis. These findings reflect the pre-trhrombotic state and injured vascular endothelium in HDG with AVF problems. Thus, Hemodialysis patients must be screened and evaluated by means of pre-thrombotic events for better AVF survival and outcome.
Abstract (Original Language): 
Hemodiyalize giren hastalarda trombotik yöne doğru eğilim artmıştır. Bu nedenle bu hastaların hemostatik durum yönünden araştırılması planlanmıştır. Araştırma için hemodiyalize giren 45 hasta ile (27 erkek, 18 kadın) 15 sağlıklı kontrol grubu (8 erkek, 7 kadın) hemostatik parametreler açısından karşılaştırıldı. Hemodiyaliz hastalarında APC rezistansı ve rezistans oranının yüksek olduğu, AT- III ve tPA antijen düzeylerinin düşük olduğu saptandı. AVF trombozu olan vakalarda tromboz öyküsü olmayan AVF hastalarına göre anlamlı bir şekilde vWF antijen seviyelerinin yüksek olduğu saptandı. Hemodiyalize giren hastalarda APC rezistansının yüksek olduğunu, bu yüksekliğin pre-trombotik duruma yardımcı olabileceğini, AT III düşüklüğünün de yine pre-trombotik durum yönünden etkiyebileceğini, tPA düşüklüğünün hipofibrinolizi yansıttığını ve bu yüzden pretrombotik durum olarak etki edebileceğini, AVF problemi olan hastalarda vWF yüksekliğinin bunlardaki vasküler endotel hasarının daha fazla olduğunu ve bunun da trombojenik bir faktör olarak pretrombotik duruma katkı edebileceğini gösterdi. Hemodiyalize giren hastalarda tormbotik AVF problemlerinde pre-trombotik durumların taranması ve araştırılması, AVF sağkalımı açısından önemli bir yaklaşımdır.
71-75

REFERENCES

References: 

1. Fan P.Y, Schwab S.J. Vascular access: Concepts for the 1990’s. J Am Soc
Nephrol 1992; 3:1.
2. Windus D.W. Permanent vascular access: A nephrologist’s view. Am J
Kidney Dis 1993; 21:457.
3. Feldman H.I, Kobrin S, Wasserstein A. Hemodialysis vascular acces
morbidity. J Am Soc Nephrol 1996; 7:523-535.
4. Feldman H.I, Held P.J, Hutchinson J.T, Stoiber H, et al. Hemodialysis
vascular access morbidity in the United States. Kidney Int 1993; 43:1091-
1096.
5. Carlston D.M, Duncan D.A, Naessens J.M, Johnson W.J. Hospitalization in
dialysis patients. Mayo Clin Proc 1984; 59:769-775.
6. Schwab S.J, Besarab A, Beathard G, Bouwer D, et al. National Kidney
Foundation DOQI Clinical practice guidelines for hemodialysis vascular
access working group. Am J Kidney Dis 1997; S154-S196.
7. Hocking W.G. Hematologic abnormalities in Patients with renal disease.
Hematology/Oncology Clinic North America 1987; 1(2):229-249.
8. Rabelink TJ, Zwaginga JJ, Koomans H.A, Sixma JJ. Thrombosis and
Hemostasis. Kidney International 1994; 46:287-296.
9. Erdem Y, Haznedaroğlu İC, Çelik İ, Yalçın AU, Yasavul Ü, Turgan Ç, Çağlar
Ş. Coagulation, fibrinolysis and fibrinolysis inhibitors in haemodialysis
patients: contribution of arteriovenous fistula. Nephrol Dial Transplant 1996;
11:1299-1305.
10. Vaziri N.D, Gonzales E.C, Wang J, Said S. Blood coagulation, fibrinolytic,
and inhibitory proteins in End-Stage Renal Disease: Effect of hemodialysis.
Am J Kidney Dis 1994; 23(6):828-835.
11. Winter M, Needham J, Mackie I, Cameron J.S. Impaired vessel wall
response to venous occlusion in patients with chronic renal failure on
maintenance hemodialysis. Clin Nephrol 1984; 22:307-313.
12. Deguchi K, Izumi K, Noguchi M, Wada H, Shirakawa S. Response of the
cubital vein to occlusion and calcification of teh abdominal aorta in patients
with chronic renal failure on maintenance hemodialysis. Throm Res 1988;
49:69-77.
13. Vaziri ND, Kennedy S.C, Kennedy D. Coagulation, fibrinolytic and inhibitory
proteins in acute myocardial infarction and angina pectoris. Am J Med 1992;
93:651-657.
14. Vaziri N.D. Nephrotic syndrome and coagulation and fibrinolytic
abnormalities. Am J Nephrol 1983; 3:1-6.
15. Meade TW, Chakrabarti R, Haines AP, North WRS, Thompson SG.
Haemostatic function and cardiovascular death: early results of a
prospective study. Lancet 1980; 1:1050-1054.
16. Vaziri ND, Smith DHG, Winer RL, Weber MA, Gonzales E, Neutel JM.
Coagulation and inhibitory and fibrinolytic proteins in essential hypertension.
J Am Soc Nephrol 1993; 4:222-228.
17. Horkko S, Miller E, Dudl E, Reaven P, Curtiss L.K, et al. Antiphospholipid
antibodies are directed against epitopes of oxidized phospholipids. J Clin
Invest 1996; 98:815-825.
18. Meytes D, Bogin A, Dukes P, et al. Effect of parathyroid hormone on
erythropoiesis. J Clin Invest 1981; 67:1263.
19. Remuzzi G, Benigni A, Dodesini P, Schieppati A, et al. Parathyroid hormone
inhibits human platelet function. Lancet 1981; 11:1321-1323.

Thank you for copying data from http://www.arastirmax.com