Background:

Kidney disease causes alterations of hemostasis increasing the risk of thrombotic and hemorrhagic events.

Objective:

Describe coagulation abnormalities in patients with kidney disease and dialytic urgency according to thrombelastography and conventional tests.

Materials and methods:

Case series of 60 patients hospitalized due to dialytic urgency. Blood samples were taken prior to implantation hemodialysis catheter or peritoneal catheter, processed for thrombelastography and conventional tests.

Results:

In the global interpretation of the thrombelastography hypercoagulable state was identified in 60% of the patients. In the individual analysis of the parameters of the plot, alterations in the enzymatic phase were demonstrated with an increased angle-α in 61.7% and shortened R time in 58.3% of the cases, alterations in the cellular phase with increased MA and G by about 45% and hyperfibrinolysis in 18%. The aPTT was prolonged by 23.7% of cases.

Conclusions:

In the overall interpretation of the thrombelastography of patients with dialytic urgency, the most frequent disorder was the hypercoagulable state. In the individual analysis, alterations were found in all the phases of coagulation, the most frequent being the accelerated formation of the clot, followed by an increase in strength. Thrombelastography should be considered as point-of-care test for the assessment of hemostasis in these patients.

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