Abstract
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<0.001 in each case). The activated partial thromboplastin time was prolonged (P<0.001) and the thrombin clotting time was decreased (P<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<0.05). Within the fibrinolytic pathway, decreased concentrations of plasminogen were found (P<0.001) and the concentrations of alpha-2-antiplasmin were increased (P<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<0.001) and inversely correlated with factor VII concentrations (P<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.
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Jones, C.L., Andrew, M., Eddy, A. et al. Coagulation abnormalities in chronic peritoneal dialysis. Pediatr Nephrol 4, 152–155 (1990). https://doi.org/10.1007/BF00858827
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DOI: https://doi.org/10.1007/BF00858827