title: Thrombophilic factors in Stage V chronic kidney disease patients are largely corrected by renal transplantation.
abstract: BACKGROUND
  The aim of our study was to evaluate the prevalence of acquired thrombophilic factors in Stage V chronic kidney disease (CKD) patients according to dialysis modality, the rate of correction of these factors 1 month after renal transplantation and their impact on cardiovascular or thromboembolic events at 1 year.
  
  
  METHODS
  Three hundred and ten patients were prospectively screened for seven thrombophilic factors at transplantation; 215 of them were also assayed 1 month after. All the patients received prophylactic acetylsalicylic acid, started before transplantation.
  
  
  RESULTS
  The prevalence of thrombophilic factors was significantly higher in patients under dialysis (n = 289) than in patients not yet on dialysis (n = 21) (74 versus 52.4%; P = 0.03) but was similar in haemodialysis and peritoneal dialysis patients (74.2 versus 73.2%). One month after transplantation, the global prevalence of thrombophilic factors had dropped from 74.4 to 44.7% (P < 0.001). Most thrombophilic factors had disappeared after transplantation: antithrombin deficiency: 13.5 versus 0.9%; P < 0.001, protein C deficiency: 12.1 versus 1.9%; P < 0.001, protein S deficiency: 3.7 versus 1.4%; P = 0.1, lupus anticoagulant: 37.7 versus 8.4%; P < 0.001 and antiphospholipid antibodies: 29.3 versus 12.6%; P < 0.001. The prevalence of activated protein C resistance, which reflects inherited factor V (FV) Leiden, was unchanged (1.9%), while the prevalence of elevated factor VIIIc increased from 20.9 to 30.7%, P < 0.001. The incidence of cardiovascular or thromboembolic events 1 year after transplantation was similar in patients with more than or equal to one thrombophilic factor at 1 month (5.2%) versus thrombophilic-free patients (6.7%).
  
  
  CONCLUSIONS
  Acquired thrombophilic factors are highly prevalent among Stage V CKD patients. Most thrombophilic factors are corrected 1 month after transplantation.
authors.affiliation: Renal Transplantation Clinic, University of Brussels-Erasme Hospital, Brussels, Belgium. lidia.ghisdal@erasme.ulb.ac.be
authors.forename: Lidia
authors.initials: L
authors.lastname: Ghisdal
authors.forename: Nilufer
authors.initials: N
authors.lastname: Broeders
authors.forename: Karl Martin
authors.initials: KM
authors.lastname: Wissing
authors.forename: Joseph Mbaba
authors.initials: JM
authors.lastname: Mena
authors.forename: Anne
authors.initials: A
authors.lastname: Lemy
authors.forename: Walter
authors.initials: W
authors.lastname: Wijns
authors.forename: Olivier
authors.initials: O
authors.lastname: Pradier
authors.forename: Vincent
authors.initials: V
authors.lastname: Donckier
authors.forename: Judith
authors.initials: J
authors.lastname: Racapé
authors.forename: Pierre
authors.initials: P
authors.lastname: Vereerstraeten
authors.forename: Daniel
authors.initials: D
authors.lastname: Abramowicz
mesh_terms: D001779:Blood Coagulation Factors / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis; D019851:Thrombophilia / Q000517:prevention & control*
chemical_list: D001779:Blood Coagulation Factors