TITLE:
Evaluation of Bleeding Risk by Hemostatic Parameters in Hemodialysis at the Douala General Hospital: Comparison between Patients on Hemodialysis before 3 Months and after 12 Months
AUTHORS:
Fouda Menye Epouse Ebana Hermine Danielle, Elimby Lionel, Dongmo Tsague Elvire, Ali Nasser, Ngo Bitoungui Valentina Josiane, Halle Marie Patrice, Ngouadjeu Dongho Eveline
KEYWORDS:
Thrombocytopenia, Prolongactivated Prothromplastin Time, Hemodialysis, Cameroon
JOURNAL NAME:
Open Journal of Nephrology,
Vol.13 No.1,
March
10,
2023
ABSTRACT: Background: Bleeding disorders are common and may be a life-threating complication among patients with End Stage Kidney Disease (ESKD), especially for those in hemodialysis (HD). Bleeding risk can be evaluated by hemostatic parameter such as platelet count, prothrombine time (PT) or activated prothromplastin time (aPTT) and may be influenced by duration in HD. Objective: Evaluate bleeding risk in HD patients by analyzing some hemostatic parameters according to duration in dialysis. Patients and methods: We conducted a cross sectional study of 3 months (March to May 2022) in the HD center of the Douala General Hospital. All consenting adult patients with ESKD admitted in HD for less than 3 months or more than 12 months were included. Bleeding risk was evaluated by platelet count, PT, aPTT and fibrinogen. Chi-square test and logistic regression were used to compare data and evaluate association with hemostatic disorder. Results: A total of 80 (60% male) patients were included; 30 patients were on HD for less than 3 months and 50 for more than 12 months. Median age was 45 [30 - 60] years in the first group and 43 [30 - 55] years in the second group. Increased bleeding risk was noted in 50% (n = 40) of patients and was similar in both groups. Thrombocytopenia was more common in patients on HD ≥ 12 months (20% (n = 6) vs 44% (n = 22), p = 0.02). Prolong aPTT was more common in HD patients ≥ 3 months (OR = 6.6 [1.88 - 23.5], p = 0.0013) and those with HD catheter (OR = 21.3 [4.6 - 45.7], p