title: Thrombophilic disorders:  a real threat to patients with end-stage renal disease on hemodialysis and at the time of renal transplantation.
abstract: Management of end-stage renal disease is the mainstay of prevention of renal vascular complications and kidney rejection. We sought to describe the association of some disorders such as diabetic nephropathy, polycystic renal disease, hypertension, and thrombophilia with renal failure and discuss possible mechanisms explaining the implication of the thrombophilic states in kidney allograft thrombosis and renal rejection. Five hundred and sixty-eight patients were included in this case-control study and multivariate analysis was applied. Cases and controls were tested for all major types of thrombophilia. Diabetic nephropathy, autosomal dominant polycystic kidney disease, hypertension, and smoking are the strongest causal agents of end-stage renal disease in Tunisia. It should also be noted that the prevalence of factor V Leiden (P = 0.05) and protein C deficiency (P = 0.005) were significantly higher in ESRD patients awaiting renal transplantation than controls. The present study has raised the possibility that thrombophilic factors may play a pathophysiological role in renal failure. These results will serve as a basis for anticoagulant prophylaxis aimed at preventing kidney rejection and renal allograft thrombosis.
authors.affiliation: Unit of Molecular Biology, Department of Hematology, Military Hospital of Tunis, Tunis, Tunisia. gksarrah@yahoo.fr
authors.forename: Sarra
authors.initials: S
authors.lastname: Klai
authors.forename: Najiba
authors.initials: N
authors.lastname: Fekih-Mrissa
authors.forename: Anouer
authors.initials: A
authors.lastname: Ghachem
authors.forename: Anis
authors.initials: A
authors.lastname: Baffoun
authors.forename: Brahim
authors.initials: B
authors.lastname: Nciri
authors.forename: Jalel
authors.initials: J
authors.lastname: Hmida
authors.forename: Nasreddine
authors.initials: N
authors.lastname: Gritli
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003928:Diabetic Nephropathies / Q000097:blood* / Q000150:complications / Q000473:pathology; D005165:Factor V / Q000235:genetics; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D007690:Polycystic Kidney Diseases / Q000097:blood* / Q000150:complications / Q000473:pathology; D020151:Protein C Deficiency / Q000097:blood* / Q000150:complications / Q000473:pathology; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology; D012307:Risk Factors; D012907:Smoking; D019851:Thrombophilia / Q000097:blood* / Q000150:complications / Q000473:pathology; D014416:Tunisia
chemical_list: C095381:factor V Leiden; D005165:Factor V