Internal Medicine: Open Access
Open Access

Abstract

Thrombosis in Hemodialysis Patients; Their Association with Tissue Factor and Tissue Factor Pathway Inhibitor

Amal Zaghloul, Talat Bukhari, Nada Bajuaifer, Maged Shalaby, Hamed Pakistani, Saeed Halawani and Shirin Teama

Background: Thrombotic complications are common in patients undergoing maintenance hemodialysis.

The aim of the study: to measure tissue factor (TF) and tissue factor pathway inhibitor (TFPI) levels in hemodialysis patients and to elucidate their role with thrombotic episodes.

Methods: 61 patients on hemodialysis as well as 19 healthy persons were included. The patients were reclassified into high and low groups according to the 90th and 10th percentile of controls of both TF and TFPI respectively to predict if higher than the 90th percentile of TF or lower than 10th percentile of TFPI were associated with thrombotic complications or not. All participants subjected to complete hemogram, measurement of TF and TFPI by enzyme linked immunosorbent assay.

Results: TF and TFPI were significantly higher in patients than control group (p<0.001and <0.05 respectively). Six patients showed at least one thrombotic episode (9.8%). TF was significantly increased (p<0.001) between the groups of patients who experienced or not thrombotic episodes. TFPI showed no significant differences in patients with or without thrombosis.TF was significantly associated with thrombosis when using multiple regression analysis, whereas TFPI was not. Patients above the 90th percentile of TF were significantly correlated with thrombosis (r=0. 4). Whereas, Patients below the 10th percentile of TFPI were not.

Conclusion: TF and TFPI increase in hemodialysis patients. TF is higher in hemodialysis patients with thrombosis whereas TFPI is not. TF above the 90th percentile is significantly correlated with thrombosis. TFPI below the 10th percentile is not. TF could be a contributor to thrombosis in hemodialysis patients.