Hemodialysis vascular access thrombosis: The role of factor V Leiden, prothrombin gene mutation and ABO blood groups.
BACKGROUND
Vascular access thrombosis increases morbidity in hemodialysis (HD) patients. The aim of this study was to investigate the association between HD vascular access thrombosis and mutations in the prothrombin and factor V Leiden (FV) genes and ABO blood system.


METHODS
This cross-sectional study included 195 patients with end stage renal disease (ESRD) on HD for more than six months. HD patients were allocated into two groups according to the occurrence (cases, N=46) or not (controls, N=149) of previous vascular access thrombosis. FV and prothrombin gene mutations were investigated by polymerase chain reaction and ABO blood group phenotyping was performed by the indirect technique. Univariate analysis detected the variables with a trend to be associated with thrombosis and was followed by multivariate analysis to define independent predictors of vascular access thrombosis.


RESULTS
FV Leiden mutation and ABO blood group were not associated with vascular access thrombosis, whereas G20210A mutation in the prothrombin gene was significantly higher in patients with vascular access thrombosis and independently associated with this complication (OR=12.0; CI 95%=1.8-83.5; p=0.012).


CONCLUSIONS
G20210A mutation emerges as an important genetic factor predisposing to vascular access thrombosis. The definition of risk factors for thrombosis will certainly enable a rational approach for HD patients.
Department of Clinical and Toxicological Analysis, Federal University of Minas Gerais, Brazil.
Danyelle R A
DR
Rios
Ana P
AP
Fernandes
Maria G
MG
Carvalho
Roberta C
RC
Figueiredo
Daniela A M
DA
Guimarães
Daniberg R
DR
Reis
Ana C
AC
Simões e Silva
Karina B
KB
Gomes
Luci M S
LM
Dusse
D000017:ABO Blood-Group System / Q000235:genetics*; D000328:Adult; D003430:Cross-Sectional Studies; D005165:Factor V / Q000235:genetics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation / Q000235:genetics*; D011516:Prothrombin / Q000235:genetics*; D006435:Renal Dialysis; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology / Q000235:genetics*
D000017:ABO Blood-Group System; C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin