1. Increased risk of dialysis circuit clotting in hemodialysis patients with <scp>COVID</scp> ‐19 is associated with elevated <scp>FVIII</scp> , fibrinogen and <scp>D</scp> ‐dimers
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Dinesha Sudusinghe, Anne Riddell, Tejas Gandhi, Pratima Chowdary, and Andrew Davenport
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Nephrology ,Hematology - Abstract
Severe COVID-19 infections increase the risk of thrombotic events and Intensive Care Units reported increased extracorporeal circuit clotting (ECC) in COVID-19 patients with acute kidney injury. We wished to determine whether hemodialysis (HD) patients with COVID-19 also have increased risk of circuit clotting.We reviewed coagulation studies and HD records, 4 weeks before and after COVID-19 polymerase chain reaction detection in HD patients between April 2020 and June 2021.Sixty-eight (33.5%) of 203 HD patients with COVID-19, 65% male, mean age 64.9 ± 15.3 years, experienced some circuit clotting, and no clotting recorded prior to positive test results. In those who experienced ECC, prothrombin, activated partial thromboplastin or thrombin times were not different, whereas median factor VIII (273 [168-419] vs. 166 [139-225] IU/dl, p 0.001), D-dimers (2654 [1381-6019] vs. 1351 [786-2334] ng/ml, p 0.05), and fibrinogen (5.6 ± 1.4 vs. 4.9 ± 1.4 g/L, p 0.05) were greater. Antithrombin (94 [83-112] vs. 89 [84-103] IU/dl), protein C (102 [80-130] vs. 86 [76-106] IU/dl), protein S (65 [61-75] vs. 65 [52-79] IU/dl) and platelet counts (193 [138-243] vs. 174 [138-229] × 10Extracorporeal circuit clotting was increased within 4 weeks of testing positive for COVID-19. Clotting was associated with increased factor VIII, fibrinogen and D-dimer, suggesting that the risk of circuit clotting was related to the inflammatory response to COVID-19.
- Published
- 2022
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