The Changes In Blood Coagulation And Its Related Influencing Factors Of Chronic Kidney Disease Patients

Objective: To study the changes in blood coagulation ofchronic kidney disease （CKD） patients, analysis of relevant influencingfactors for CKD patients with hypercoagulable and explore the relationshipbetween oxidative stress and inflammation, endothelial growth factor. Method:Select the Luzhou Medical Department of Nephrology, admitted to hospital inDecember2010to December2011CKD1～5patients,50cases in each group,and acording to Pathologically or clinically confirmed in line with the UnitedStates of CKD and dialysis clinical practice guidelines （K/DOQI） in2006onthe definition of chronic kidney disease，79cases were male （53%）, female71cases （47%）; aged18to84years, mean age （51.34±15.77） years. And choosehealthy during the same period,30cases as a control group,17cases weremale （57%）, female13cases （43%）Aged18to70years old, average age（41.07±14.27） years. Tell them and obtain the informed consent, record thename, age, gender, smoking history, the primary disease, a history ofthrombosis and bleeding, dialysis history and duration of dialysis, diabetesand cardiovascular disease. Collected fasting blood samples of CKD patientsand the control group, determinate of albumin （ALB）, cholesterol （TC）,triglycerides （TG）, creatinine （Cr）, calcium (Ca²⁺), C-reactive protein （CRP）,hemoglobin（Hb）, platelet （PLT）, specimens from blood kept Elisa detection ofvon Willebrand D-dimer （DD）,by xanthine oxidase, and thiobarbituric acid were used to detect superoxide dismutase （SOD） andmalondialdehyde （MDA）.According to the the Fbg normal （2⁴） g/L and the experimental results, selectthe FIB>4g/L of patients as the hypercoagulable group, select2<the FIB <4g/L of patients as the non-hypercoagulable group to analyse influencingfactors. Results:（1） Compared with the control group, CKD1⁵in patientswith the FIB, PT, TT, and DD compared with the baseline level of normalgroup has increased, with reduced GFR gradually increased; FIB and DD PTin CKD45, TT levels in CKD4, there is a significant difference （P <0.05）;CKD1⁵in patients in each group, the FIB, and DD in CKD4,5, PT inCKD5compared with the CKD1,the difference was statistically significant （P<0.05）. The APTT group difference was no statistically significant.（P>0.05）（2）Relevant influencing factors analysis: CKD patients with hypercoagulablegroup of ALB, Ca²⁺, SOD levels were significantly lower thannon-hypercoagulable group （P<0.05）; CR, TC, ET-1, CRP and MDA levelssignificantly higher than non-hypercoagulable group （P<0.05）;Cardiovascularoccurrence of statistically significant difference in the two groups of subjects（P<0.05）. CKD patients serum levels of FIB in the correlation analysis ofALB, CR, CRP and ET-1and of SOD and MDA were significantly related,in which ALB, SOD and FIB levels were negatively correlated （r=0.282,-0.290, P<0.05）, CR, ET-1, CRP, MDA, and FIB levels were positivelycorrelated （r=0.268,0.242,0.267,0.265, P<0.05）; Logistic regression analysisfound that serum the CR, CRP are the independent risk factor with hypercoagulable of CKD patients （P<0.05）.Conclusion:1.CKD patientscommonly have high condensate phenomenon, With the decline in GFRgradually increased,Hemodialysis further aggravate the hypercoagulable2.linical indicators TC, Ca²⁺,ALB, CR and diabetes, cardiovascular factorsmay be influencing factors of CKD hypercoagulable state;3.serum creatinineand C-reactive protein are the independent risk factor with hypercoagulable ofCKD patients;4.The hypercoagulable phenomenon in CKD patients withinflammation, endothelial dysfunction and oxidative stress is closelyrelated.