The in-vitro influence of urea concentration on thromboelastrography in patients with and without end stage renal disease - 22/11/23
, Ivan E. Rodriguez b, 1, Hunter B. Moore b, Wells LaRiviere c, Cara Crouch a, Erin Stewart a, Trevor L. Nydam b, Peter Kennealey b, Adrian D. Hendrickse a, Elizabeth A. Pomfret b, Ana Fernandez-Bustamante aAbstract |
Background |
End stage renal disease (ESRD) is associated with platelet dysfunction but also thromboembolic complications. The specific role of increased blood urea nitrogen (BUN) on coagulation is unclear. We aimed to characterize thromboelastography (TEG) parameters from males and females with ESRD and normal kidney function and evaluate if exogenous urea in vitro reproduced those TEG differences.
Methods |
We collected blood samples from 20 living kidney donors and 20 kidney recipients. TEG was performed without and with two increasing urea concentrations in vitro. TEG parameters were compared between recipients and donors.
Results |
Blood from kidney recipients showed baseline increased maximum amplitude (MA) and shortened time to maximum amplitude (TMA) compared to donors. These differences were not confirmed in females. In all patients, BUN was inversely correlated with TMA (r = −0.342; p = 0.031). In males, BUN and creatinine concentrations showed a direct correlation with MA (0.583; p = 0.007) and an inverse correlation with TMA (r = −0.520; p = 0.019). Urea in vitro decreased R-time (p = 0.005) and increased LY30 (p = 0.009) in donors but not recipients.
Conclusions |
ESRD is associated with increased MA and decreased TMA on TEG. No change in MA was observed with increasing urea concentrations in vitro. Gender-specific variability in TEG parameters were observed.
Le texte complet de cet article est disponible en PDF.Highlights |
• | No change in MA was observed with increasing urea concentrations in both donors and recipients |
• | In all patients, BUN was inversely correlated with TMA |
• | In males, BUN and creatinine concentrations showed a direct correlation with MA |
• | Urea in vitro decreased R-time and increase LY30 in healthy kidney transplant donors but not recipients. |
Keywords : End stage renal disease, Coagulopathy, Urea, Kidney transplant, Thromboelastography (TEG)
Plan
Vol 226 - N° 6
P. 817-822 - décembre 2023 Retour au numéro
Article précédent
- Impact of methocarbamol on opioid use after primary ventral and inguinal hernia repair
- Caitlin Crosier, Brooke Hammond, Cecilia Carbonell, Katherine Hoffman, Shivani Desai, Dawn Blackhurst, Alfredo M. Carbonell, Michael W. Love, William S. Cobb, Jeremy A. Warren
- Delayed versus early hepatic resection among patients with severe traumatic liver injuries undergoing damage control laparotomy
- Hamidreza Hosseinpour, Adam Nelson, Sai Krishna Bhogadi, Audrey L. Spencer, Qaidar Alizai, Christina Colosimo, Tanya Anand, Michael Ditillo, Louis J. Magnotti, Bellal Joseph
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?