Coagulation abnormalities in chronic peritoneal dialysis

• Published in: Pediatric nephrology (Berlin, West) West), 1990-03, Vol.4 (2), p.152-155
• Main Authors: JONES, C. L, ANDREW, M, EDDY, A, O'NEIL, M, ISH SHALOM, N, BALFE, J. W
• Format: Article
• Language: English
• Subjects: Adolescent; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Coagulation Disorders - etiology; Blood Coagulation Factors - metabolism; Child; Child, Preschool; Emergency and intensive care: renal failure. Dialysis management; Female; Fibrinolysis; Humans; Infant; Intensive care medicine; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - surgery; Kidney Failure, Chronic - therapy; Kidney Transplantation; Male; Medical sciences; Peritoneal Dialysis, Continuous Ambulatory - adverse effects; Renal Artery Obstruction - etiology; Renal Veins; Thrombosis - etiology
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/BF00858827

To determine whether children treated with chronic peritoneal dialysis have a hypercoagulable state, various coagulation and fibrinolytic factor concentrations or activities were measured in 17 children undergoing chronic peritoneal dialysis. The patients had significantly increased activities of factors VII and VIII, and increased concentrations of von Willebrand factor (vWF), fibrinogen, factor XIIIA and factor XIIIS compared to reference values (P less than 0.001 in each case). The activated partial thromboplastin time was prolonged (P less than 0.001) and the thrombin clotting time was decreased (P less than 0.05) in these children. The prothrombin time and activities of factors XII, XI, IX, X, V and II were not significantly different from control values. Protein C concentrations were similar to normal, but antithrombin III concentrations were increased (P less than 0.05). Within the fibrinolytic pathway, decreased concentrations of plasminogen were found (P less than 0.001) and the concentrations of alpha-2-antiplasmin were increased (P less than 0.001). The plasma albumin concentration was below 33 g/l in 13 of the 17 children. The duration of treatment with peritoneal dialysis was directly correlated with vWF concentrations (P less than 0.001) and inversely correlated with factor VII concentrations (P less than 0.01). Of these patients 2 have since had clinical thrombotic episodes. The coagulation abnormalities found may have a role in the occurrence of thrombosis complicating renal transplantation.