Coagulation Plasma Haemoglobin and D-D Levels in Patients with Diabetic Nnephropathy and The Relationship with Haemodialysis Arteriovenous Fistula Thrombosis
LI Li, XUE Lian, WU Menghan
West China Hospital of Sichuan University, Sichuan Chengdu 610041, China
Abstract：Objective: To analyze the coagulation function, levels of plasma hemoglobin (Hb) and D-dimer (D-D) in patients with diabetic nephropathy (DN) and their relationship with thrombosis of arteriovenous fistula (AVF). Methods: A total of 99 patients with DN confirmed in the hospital were enrolled between February 2020 and February 2022. According to presence or absence of AVF thrombosis, they were divided into thrombosis group (n=34) and simple DN group (n=65). The clinical data in both groups were recorded. The prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB) were detected by freezing method. The level of antithrombase-III (AT-III) and D-D were detected by chromogenic substrates assay. The international normalized ratio (INR) was the ISI power of PT to normal control PT ratio. The level of D-D was detected by immunoturbidimetry. The level of Hb was detected by colorimetry. The predictive value of the above indexes for AVF thrombosis was analyzed by ROC curves. Results: The difference in age, gender, body index (BMI), disease course and blood urea nitrogen between thrombosis group and simple DN group was not statistically significant (P>0.05). The dialysis time and usage time of AVF in simple DN group were significantly shorter than those in thrombosis group (P<0.05), and levels of AT-III, PT, APTT, TT, FIB, INR, Hb and D-D were significantly lower than those in thrombosis group (P<0.05). AUC values of AT-III, PT, APTT, TT, INR, FIB, Hb and D-D for predicting AVF thrombosis were 0.771, 0.788, 0.748, 0.778, 0.673, 0.778, 0.771 and 0.745, respectively. Combined test showed an AUC of 0.963, a sensitivity of 82.35% and a specificity of 81.54%. Conclusion: Coagulation function indexes, Hb and D-D can predict AVF thrombosis in hemodialysis patients.
2023, Vol. 29 
冀公网安备13080202000677号