ORIGINAL ARTICLE |
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Year : 2019 | Volume
: 32
| Issue : 1 | Page : 345-351 |
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Plasma levels of von Willebrand factor in maintenance hemodialysis patients: its relation to vascular access thrombosis
Hassan Abd El-Hady1, Mahmoud A Kora1, Khaled M. A. El-Zorkany1, Belal A Montaser2, Amira M. E. Yousuf3
1 Department of Internal Medicine, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt 2 Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt 3 Department of Nephrology, Benha Teaching Hospital, Banha, Egypt
Correspondence Address:
Amira M. E. Yousuf Shebeen El-Kom, Menoufia, 32511 Egypt
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/mmj.mmj_416_17
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Objective
The aim of this study was to assess von Willebrand factor (VWF) plasma levels in patients under maintenance hemodialysis (HD) to determine its role in the occurrence of vascular access thrombosis (VAT) in such patients.
Background
HD process is associated with increasing thrombotic trend especially owing to platelets and clotting factor activation. Vascular access complications increase morbidity and contribute to 20–25% of all hospitalizations in HD patients, of which ~ 85% of these cases are because of thrombosis. VWF is an important component of the hemostatic system and a hypercoagulability state biomarker.
Patients and methods
This case–control study was conducted on 60 patients on HD for more than 6 months classified into two groups: group I (GI) included 30 patients with VAT, whereas group II (GII) included 30 patients without VAT. Moreover, 20 healthy individuals served as a control group. History taking, clinical examination, and investigations (complete blood count, kidney function tests, liver function tests, lipid profile, fasting blood sugar, postprandial blood sugar, and serum VWF) for all cases were done.
Results
Mean VWF serum level was found to be higher in HD groups (GI 1361.47 ± 270.38 and GII 950 ± 138.12) than control group (351.5 ± 34.8), with highly statistical significance. A cutoff level of VWF at 1277 ng/ml is accurate (46.67%) for ocurrance of VAT in GI patients, with sensitivity of 93.33%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 93.8%.
Conclusion
High VWF levels related to development of VAT.
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