Before and after dialysis antithrombin III levels in patients on continuous hemodialysis

Objective: Both bleeding tendency and thrombotic complica¬tions are seen together in advance renal failure. Because oj the blood contacts on artificial surface during hemodialysis the activation of platelets and clotting factors lead to clot for¬mation in the extracorporeal circuit and this still remains as a potential problem. Patients undergoing regular hemodialysis are subject to height risk of thrombotic complications. The low levels of antithrombin III play a role with the genesis oj these complications. AT III is a major inhibitor of blood co¬agulation and hereditary deficiency is associated with venous thrombotic disease. We measured plasma AT III, fibrinojen, active partial thromhoplastine time (aPTT) and protrombin time (PTT) in order to investigate the activation of coagulati¬on before and after dialysis in patients with chronic renal fa¬ilure undergoing regular hemodialysis.
Study Design: Patient group was 50 people and control gro¬up was 20 people. We determined AT III via cromogenic substrat method, by using Hitachi-717 otoanalyzer produced by Boehringer Mannheim.
Results: We found the mean value for AT III activity 103,8%±8,85 in healthy controls. The mean values for AT III before dialysis and after dialysis were respectively 84,56%±I3,0 and 99%±J4,12 in patients with chronic renal failure. Conclusions: As compared with the healthy controls, the pa¬tients with chronic renal failure had significantly lower (p: 0.000) AT III activity before dialysis and significantly inc¬reased AT III activity after dialysis, (p: 0.000)

Hemodiyalize giren hastalarda diyaliz öncesi ve sonrasý Antitrombin III deðerleri

Amaç: Heri dönem böbrek yetersizliðinde trombotik kompli- kasyonlar ve kanamaya eðilim bir arada görülür. Hemodiya- liz esnasýnda karým suni yüzeylerle temasý sonucunda trombo- sitlerin ve pýhtýlaþma faktörlerinin aktivasyonuyla ekstrakor- poral pýhtýlaþmanýn meydana gelmesi güçlü bir sorun olarak karþýmýza çýkmaktadýr. Regüler hemodiyalize giren iiremik hastalar tromhoz komplikasyonlarý açýsýndan büyük risk al- týndadýr. Bu komplikasyonlarýn oluþmasýnda düþük antitrom- bin III (AT III) seviyeleri de rol oynaý: Kan pýhtýlaþmasýnýn majör doðal inhibitörü olan AT III’iin kalýtsal eksikliði venoz trombotik hastalýklarla birliktelik gösterir. Biz düzenli olarak hemodiyalize giren kronik böbrek yetersizliði hastalarýnda (koagiilasyon aktivasyonunu incelemek için) diyalize girme- den hemen önce ve diyalizden hemen sonra fibrinojen, aPTT, protrombin zamaný ve ÂT III aktivitelerini tayin ettik.
Gereç ve Yöntem: Hasta grubu düzenli diyalize giren 50 kiþi, kontrol grubu ise saðlýklý 20 kiþiydi. AT III tayinleri kromoje- nik substrat yöntemi kullanýlarak Boehringer Mannheim- Hi- tachi 717 otoanalizoründe çalýþýldý.
Bulgular: Kontrol grubunda AT III aktivitesini ortalama %I03,8±8,85 bulduk. Hasta grubunda; diyaliz öncesi AT III aktivitesini ortalama %84,56±I3,0, diyalizden sonra %99± 14,12 olarak bulduk.

Sonuç: Hasta grubunda diyaliz öncesi AT III aktivitesi kont- rol grubuna kýyasla anlamlý bir þekilde düþüktür p: 0.000 Di- yaliz sonrasý AT III aktivitesinde anlamlý bir artýþ kaydedil- miþtir (p: 0.000).