Haemostatic defects in chronic kidney disease

Objective: to study haemostatic defects in stage iii and stage iv chronic kidney disease and to study coagulation marker in these patients. material and methods: this study was conducted in the nephrology and haematalogy department of shaikh zayed hospital,lahore from june 2010 to december 2010. the study included a total of 150 patients,50 for stage iii chronic kidney disease,50 for stage iv chronic kidney disease and 50 for control group. bleeding time prothrombin time,aptt,platelet count and d-dimer were performed on these patients. results: a significantly elevated level of d-dimer was found in 93% of the patients of stage iii and stage iv chronic kidney disease. for stage iii p. value.001 and for stage iv p. value.001 significantly elevated as compared to the control group less than 250ng /ml. both pt and aptt for stage iii and stage chronic kidney disease were within normal range. bleeding time in stage iii was within normal range,while in stage iv only 5 out of 50 patients had prolonged bleeding time. which was significantly elevated as compared to control group (p. value <.002) platelet count in stage iii,only 5 patients out of 50,had thrombocytopenia,while in stage iv only 9 out of 50 patient had low platelet count. mean platelet count in stage iii was 118.40 × 103/μl and in stage iv 115.44 × 103/μl thrombocytopenia seen in stage iii and stage iv showed significant association with to disease of when compared with normal control group stage iii p. value <.004 stage iv p <.005. conclusion: chronic kidney disease both stage iii and stage iv is assoated with coagulation abnormalities and bleeding disorder. so watch the patients closely with chronic kidney disease to avoid complication of bleeding tendency or thromboembolic phenomenon.