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Intravascular Depletion of
deposition of platelets and
fibrin coagulation
factors
Thrombosis of
small and Bleeding
midsize vessels
and organ failure
:Laboratory findings *
Prolonged prothrombin time, activated partial -
. thromboplastin time and thrombin time
- Decreased fibrinogen levels.
- Increased levels of fibrin degradation products
and D-dimer tests.
- Relative or absolute decrease of Platelet count.
- Presence of schistocytes in peripheral smear.
Cont.
*Laboratory findings:
- Modestly increased prothrombin time
in some patients
- Shortened or lengthened partial
thromboplastin time.
- Normal thrombin time in most patients.
- High, normal or low platelet count.
- Increased levels of fibrin degradation products
and D-dimer.
Cont.
What is D-dimer ?
Study population:
Patients diagnosed as chronic renal failure (CRF).
Study location:
The study conducted in central laboratory at Gezira hospital
for renal diseases and surgery.
Cont.
Study design:
It was an observational prospective comparative
case control study.
:Data collection
A questionnaire was designed to collect
demographical and clinical data.
Using latex agglutination slide test for
qualitative and semi-quantitative assay.
Cont.
Note:
In addition to D-dimer & FDPS tests, we
performed both PT & APTT tests.
Age Distribution
: 30
27
25
20
17
15
13
10
Percent
3
0
10-20 21-30 31-40 41-50 51-60 61-70
age group
Cont.
Sex
distribution :
Male 71.7%
(I n (43
Female
28.3%
In (17)
Cont.
Type of
No of patients Percent %
dialysis
Peritoneal
Dialysis 20 33.3
Haemodialysis 40 66.7
Total 60 100.0
Cont.
Duration /
No. of patients Patient %
months
1-6 20 50.0
7-12 10 25.0
13-18 3 7.5
19-24 2 5.0
25-30 1 2.5
31-36 1 2.5
37-42 1 2.5
43-48 2 5.0
Total 40 100.0
Cont.
1 6 30.0
2 8 40.0
3 4 20.0
4 1 5.0
6 1 5.0
Total 20 100.0
Cont.
Level of
Type of dialysis Frequency Patient %
FDPS
< 5.0 5 25.0
Peritoneal > 5.0 < 20 4 15.0
Dialysis > 20 11 60.0
Total 20 100.0
Pre PT
Peritoneal 20 16.6
& post 0.98 0.189
Dialysis 20 16.2
PT
All controls (n=60 ) were normal for both D-dimer (<0.5µg/ml) &
FDPs (<5.0µg/ml).
D-dimer is a blood test performed in the medical
laboratory to diagnose I.V. thrombosis. When clots
are formed at the wrong time and place as a result of
underlying disease, D-dimer becomes available
marker because its presence indicates the
occurrence of unwanted thrombotic events.
In this study the majority of the cases (38.3%)
were 50 years and above. At this age we expect
co-morbid conditions, which warrant a timely
multidisciplinary approach towards the management
of chronic renal failure.
Cont.