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Hemostatic changes in patients undergoing hemodialysis: Differences between central venous catheters and arterio-venous fistulas.
Cunha, Mayara Dumont; Ottoni, Marcelo Henrique Fernandes; da Silva, Natalia Cristina; Araújo, Samuel Jorge Teixeira; Duarte, Rita Carolina Figueiredo; Lucas, Thabata Coaglio.
Afiliação
  • Cunha MD; Department of Nursing, Federal University of the Valleys of Jequitinhonha and Mucuri, Diamantina, Brazil.
  • Ottoni MHF; Department of Pharmacy, Laboratory of Immunology, Federal University of the Valleys of Jequitinhonha and Mucuri, Diamantina, Brazil.
  • da Silva NC; Department of Medicine, Postgraduate Program in Health Science, Federal University of the Valleys of Jequitinhonha and Mucuri, Diamantina, Brazil.
  • Araújo SJT; Department of Nursing, Federal University of the Valleys of Jequitinhonha and Mucuri, Diamantina, Brazil.
  • Duarte RCF; Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Hematology, Federal University of Minas Gerais, Belo Horizonte, Brazil.
  • Lucas TC; Department of Nursing, Graduate Program in Health Science, Federal University of the Valleys of Jequitinhonha and Mucuri, Diamantina, Brazil.
Artif Organs ; 46(9): 1866-1875, 2022 Sep.
Article em En | MEDLINE | ID: mdl-35451088
BACKGROUND: Failure to mature the fistula in patients undergoing hemodialysis leads to prolonged use of the central venous catheter (CVC) and can compromise the patency of the catheter and the arteriovenous fistula (AVF) due to thrombus development. OBJECTIVE: To evaluate hemostatic changes in patients undergoing hemodialysis with prolonged use of CVC or AVF. METHOD: Cross-sectional study with a total of 200 adult participants who were divided into the following groups: I:control; II: patients who had 5-8 months of CVC insertion; III: patients who had 9-36 months of insertion; IV patients who had 5-8 months of AVF; and V: patients who had 9-36 months of AVF. Platelet activation was investigated by expressions of GPIIb/IIIa and p-selectin using flow cytometry. The Elisa-thrombomodulin (TM) test was used to compare groups III and V. RESULTS: The p-selectin percentage expression of group I was 15.30 (12.30-16.80), II 23.25 (20.75-30.55); and III 54.00 (44.75-59.29) were significant (p < 0.001). Groups I, IV, and V were also significant (p < 0.001). The median fluorescence for GPIIb/IIIa for groups I, II, and III were significant (p < 0.0001). As for the Elisa test, an increased absorbance of TM was verified in patients who used the CVC 4372 (3951-4733) compared with those patients who used the AVF 2162 (1932-2485) (p < 0.0001). CONCLUSION: It can be concluded that CVC patients had a larger platelet expression of GPIIb/IIIa and p-selectin than AVF patients. The high concentration of TM in CVC patients may suggest a greater stimulation of the intrinsic than extrinsic coagulation pathways.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hemostáticos / Derivação Arteriovenosa Cirúrgica / Fístula Arteriovenosa / Cateteres Venosos Centrais / Falência Renal Crônica Tipo de estudo: Etiology_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: Artif Organs Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hemostáticos / Derivação Arteriovenosa Cirúrgica / Fístula Arteriovenosa / Cateteres Venosos Centrais / Falência Renal Crônica Tipo de estudo: Etiology_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: Artif Organs Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos