Ribeiro S, Carvalho F, Remedio F, Vila A, et al.
Vascular access thrombosis and antiphospholipids in
hemodialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1418 1996
Coagulation factors including antiphospholipid antibodies, antithrombin III
protein S and protein C can produce a hypercoagulable state. Their
presence could correlate with increasing risk of vascular access thrombosis
in hemodialysis patients.
The authors studied 78 patients on dialysis fro the presence of these
antibodies and found that 25.6% were positive anti-phospholipid antibodies
(20.5% for IgG-anticardiolipin antibodies). Vascular access thrombosis
(VAT)was seen in 24.4% overall. No correlation was noted betwween antibody
levels and VAT.
Comment: The presence of abnormal coagulation factors in patients
with AV graft thrombosis has been noted in some studies, especially
anti-phospholipid antibodies
(see Abstract # 880). Routine measurement of
these factors is not warranted but may be appropriate in patients with
otherwise unexplained recurrent access thrombosis. Coumadin therapy may be
helpful in such patients with antiphospholipid antibodies but the optimal
INR target is unknown.
(Harold Bregman, M.D., Lutheran General Hospital, Park Ridge,
IL)
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Am Soc Nephrol
Basic hemodialysis :
Vascular Access: graft/fistula