title: Assessment of the Hemostatic Parameters and Platelet Function on Thromboelastometry and Impedance Aggregometry in Hemodialysis Patients Qualified for Kidney Transplantation: Preliminary Report.
abstract: BACKGROUND
  Chronic kidney disease is one of the medical conditions that affect hemostasis. Patients undergoing hemodialysis present both hemorrhagic and prothrombotic tendencies. Platelet adhesion to the artificial surface of the dialyzer's membrane, blood vessel endothelial wall disruption, and quantitative and qualitative changes in clothing factors are thought to be causative agents of the above-mentioned conditions. Thromboelastometry and impedance aggregometry enable precise assessment of clot formation and platelet function abnormalities, including changes related to chronic renal failure in patients undergoing renal replacement therapy.
  
  
  METHODS
  A prospective study with control group was designed. The study group consisted of 17 adults with diagnosed chronic renal failure undergoing hemodialysis. The control group consisted of 13 healthy volunteers. EXTEM and FIBTEM tests in rotational thromboelastometry and TRAPtest in impedance aggregometry analyzer were performed.
  
  
  RESULTS
  EXTEM parameter test results were comparable between analyzed groups, whereas FIBTEM test results were significantly increased in the study group. Platelet aggregation as measured by the TRAPtests was significantly decreased in patients undergoing hemodialysis.
  
  
  CONCLUSIONS
  In end-stage renal disease patients undergoing hemodialysis, whole-blood clot formation is not disturbed, even though platelet dysfunction occurs. Increased fibrin clot formation reflected by FIBTEM results may compensate the observed platelet disorders. The compilation of ROTEM and Multiplate may support appropriate hemostatic control and decision-making during kidney transplantation.
authors: Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Poland. Electronic address: jan.pluta@lekarz.eu.
authors: J
authors: J
authors: Pluta
authors: Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Poland.
authors: B
authors: B
authors: Nicińska
authors: Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Poland.
authors: M
authors: M
authors: Grzeszczyk
authors: Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Poland.
authors: M
authors: M
authors: Kołacz
authors: Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Poland.
authors: L
authors: L
authors: Jureczko
authors: Department of General and Transplantation Surgery, Medical University of Warsaw, Poland.
authors: A
authors: A
authors: Kwiatkowski
authors: Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Poland.
authors: M
authors: M
authors: Durlik
authors: Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Poland.
authors: J
authors: J
authors: Trzebicki
mesh_terms: D000328:Adult; D000368:Aged; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D001792:Blood Platelets; D016022:Case-Control Studies; D017097:Electric Impedance; D005260:Female; D006487:Hemostasis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D010976:Platelet Count; D010979:Platelet Function Tests; D057234:Preoperative Period; D011446:Prospective Studies; D006435:Renal Dialysis; D013916:Thrombelastography / Q000379:methods*