title: Arteriovenous thrombosis in chronic renal failure patients receiving renal replacement therapy.
abstract: OBJECTIVE
  To determine the frequency of thrombotic complications and to identify factors associated with arteriovenous thrombosis in patients of chronic renal failure receiving renal replacement therapy.
  
  
  METHODS
  A descriptive study.
  
  
  METHODS
  The study was carried out at Sindh Institute of Urology and Transplantation (SIUT), Karachi, from May 2003 to December 2003.
  
  
  METHODS
  Of the 3000 patients evaluated, 61 End Stage Renal Disease (ESRD) patients on regular dialysis, having recent renal transplant, were selected for the study after informed consent. These patients had arteriovenous thrombosis with temporary central lines thrombosis and vascular access problems. Cases of congenital or acquired thrombotic disorders, e.g. with malignancy, DIC, liver disease, systemic lupus erythematosus or other immunologic diseases, pregnancy or women using oral contraceptives, were excluded. Similarly, patients taking any type of anticoagulant therapy during the preceding one week were not included in the study. Findings were recorded in a structured questionnaire. Laboratory analysis was done after clinical and radiological evaluation. Thrombophilia screening included antithrombin, protein C, protein S deficiencies and lupus anticoagulant.
  
  
  RESULTS
  Forty-seven out of 61 patients selected were positive for thrombophilia screening with protein C deficiency in 26.2%, protein S deficiency in 16.3%, antithrombin in 5%, lupus anticoagulant in 13.1% and combined deficiency was observed in 16.3%.
  
  
  CONCLUSIONS
  Of the 3000 patients, 61 with frequency of 2% were found to be deficient in one or had combined deficiency of these. Thus, the study of ESRD patients presenting with arteriovenous thromboembolism emphasizes the need to reconsider the perception that this clinical entity is rare and requires further studies.
authors.affiliation: Sindh Institute of Urology and Transplantation (SUIT), Karachi. drmunirashoaib@yahoo.com
authors.forename: Munira
authors.initials: M
authors.lastname: Shoaib
authors.forename: Tahir S
authors.initials: TS
authors.lastname: Shamsi
authors.forename: Arshi
authors.initials: A
authors.lastname: Naz