Brent J. Portz
WASHINGTON — Research presented at ASN Kidney Week suggested that use of a tool that measures clot stiffness could help monitor patients on dialysis for vascular access complications.
“We know that those in the ESRD population are predisposed to prothrombotic state,” Brent J. Portz, of the division of nephrology at the University of Virginia, told Healio Nephrology in an on-site interview. “These patients have the tendency to form clots and are hypercoagulable in general. Forming clots can cause vascular access malfunctions, resulting in ineffective dialysis. This is a major struggle for us [as nephrologists] and it’s tedious for the patients, as well.”
Hypothesizing that blood clot elasticity might be helpful in diagnosing vascular access complications, researchers measured a variety of coagulation markers (including fibrinogen and platelet count) in 21 patients on hemodialysis during the course of 3 months. Of these patients, five had recurrent vascular access failure caused by concurrent thrombosis and stenosis, nine had recurrent access stenosis without thrombosis and five had functioning access without complications. Sonorheometry ultrasound technology (Quantra QPlus Cartridge) measured coagulation parameters, including clot stiffness, for each patient.
Researchers found that although there were no statistical differences in stiffness parameters among the three groups of patients, those with recurrent vascular access complications caused by thrombosis/stenosis had high clot stiffness values.
“Sonorheometry is something we can potentially use in the future to help assess patients’ coagulability when there’s a question of whether we need access intervention,” Portz said. “This is also something we might be able to use going forth for potential new development of novel agents for anticoagulation.” – by Melissa J. Webb
Wentworth D, et al. Abstract TH-PO349. Presented at: ASN Kidney Week; Nov. 7-10, 2019; Washington, D.C.
Disclosure: Portz reports no relevant financial disclosures.