Risk Factors Analysis of Hypercoagulability in Patients with Chronic Kidney Disease by Thrombelastograph / 中国药师

ABSTRACT

Objective: To evaluate the risk factors of hypercoagulability in the patients with chronic kidney disease (CKD) by thrombelastograph.Methods:According to the maximal elasticity of thrombus(MA),221 patients with chronic kidney disease under-going thromboelastography were divided into two groups low coagulation group (MA<69mm, n=139) and high coagulation group (MA≥69mm,n=82). The basic conditions of the two groups were analyzed respectively, including gender, age, height, weight, concomitant diseases such as diabetes mellitus,hyperlipidemia and nephrotic syndrome,medication situation such as recombinant hu-man erythropoietin,anti-platelet drugs and hormones,renal function such as CKD1-3 stages and CKD4-5 stages,clotting parameter re-sponse time(R value),clotting time(K value),angle α,maximum thrombus(MA)and the other coagulation-related indicators such as platelet PLT,and binary logistic regression was used to analyze the risk factors causing hypercoagulability. Results:There were no significant differences in age,gender,height and weight etc(P>0.05)while there were significant differences in concomitant diseases, drug use,renal function, coagulation indicators including thrombus elasticity and blood index between the groups (P<0.05). The risk factors of hypercoagulation mainly included disease factors (diabetes OR 1.895,95% CI 1.082-3.318, nephrotic syndrome OR 2.501,95% CI 1.429-4.379,CKD4-5 stage OR 1.989,95% CI 1.136-3.483),and drug factors(recombinant human erythropoietin rHuEPO)(OR 2.254,95% CI 1.207-4.208). Conclusion: In the patients with CKD, diabetes mellitus, nephrotic syndrome and CKD4-5 stages increase the hypercoagulability of patients,and rHuEPO also increases the risk of hypercoagulability in the patients with renal anemia.