Evaluation of Blood Coagulation Parameters in Chronic Kidney Diseases

Patients with chronic kidney disease (CKD) are prone to haemorrhage and/or thrombi formation, suggesting abnormalities in haemostasis. The study aimed to investigate the impairment of coagulation factors in CKD patients. One hundred and twenty-three (123) CKD patients, who were attending Prince Hamza and Al-Karak public hospitals, and fifty (50) healthy subjects (control) were recruited for the study. CKD patients were subcategorized according to their GFR value into III B and IV groups. Ethical approval was obtained, and all participants consented to the study. Whole blood samples were collected from all the CKD patients and 50 control (healthy) subjects and tested for prothrombin time (PT), activated partial thromboplastin time (aPTT), and coagulation factors I (fibrinogen), II, V, VII, VIII, IX, X, XI, and anti-thrombin III (ATIII) on STA coagulation analyzer. The levels of proteins C, S, and von Willebrand factor (VWF) were measured using enzyme-linked immunosorbent assay (ELISA). The findings showed a significant prolonged PT and aPTT in CKD patients compared to the control (healthy) subjects, and the level of F-V and F-XI were significantly decreased, justifying the clinical manifestation of bleeding in CKD patients. However, factors VII, VIII, and IX were increased significantly in CKD patients. The findings from this study have demonstrated that CKD impairs the coagulation factors and leads to an increase in the time required for clot formation, suggesting a tendency of patients with CKD to have frequent bleeding episodes.