Hallmarks for Thrombotic and Hemorrhagic Risks in Chronic Kidney Disease Patients.

Publisher: MDPI Country of Publication: Switzerland NLM ID: 101092791 Publication Model: Electronic Cited Medium: Internet ISSN: 1422-0067 (Electronic) Linking ISSN: 14220067 NLM ISO Abbreviation: Int J Mol Sci Subsets: MEDLINE

Original Publication: Basel, Switzerland : MDPI, [2000-

Renal Insufficiency, Chronic*/complications ; Renal Insufficiency, Chronic*/therapy ; Thrombosis*/etiology ; Hemorrhage*/etiology; Humans ; Risk Factors ; Anticoagulants/therapeutic use ; Blood Coagulation ; Animals

Chronic kidney disease (CKD) is a global health issue causing a significant health burden. CKD patients develop thrombotic and hemorrhagic complications, and cardiovascular diseases are associated with increased hospitalization and mortality in this population. The hemostatic alterations are multifactorial in these patients; therefore, the results of different studies are varying and controversial. Endothelial and platelet dysfunction, coagulation abnormalities, comorbidities, and hemoincompatibility of the dialysis membranes are major contributors of hypo- and hypercoagulability in CKD patients. Due to the tendency of CKD patients to exhibit a prothrombotic state and bleeding risk, they require personalized clinical assessment to understand the impact of antithrombotic therapy. The evidence of efficacy and safety of antiplatelet and anticoagulant treatments is limited for end-stage renal disease patients due to their exclusion from major randomized clinical trials. Moreover, designing hemocompatible dialyzer membranes could be a suitable approach to reduce platelet activation, coagulopathy, and thrombus formation. This review discusses the molecular mechanisms underlying thrombotic and hemorrhagic risk in patients with CKD, leading to cardiovascular complications in these patients, as well as the evidence and guidance for promising approaches to optimal therapeutic management.

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Keywords: anticoagulants; antiplatelets; chronic kidney disease; hemodialysis membranes; hemostatic dysfunction

0 (Anticoagulants)

Date Created: 20240829 Date Completed: 20240829 Latest Revision: 20240903

20250114

PMC11354877

10.3390/ijms25168705

39201390