Pathological and radiological irregularities in patients with chronic kidney disease - An observational study

Background: Chronic kidney disease (CKD) encompasses a spectrum of different pathophysiologic processes associated with abnormal renal function and progressive decline in glomerular filtration rate (GFR). Aims and Objectives: The objectives of the study are 1) to assess basic tests and kidney function tests in patients with CKD, (2) to assess coagulation profile, sugar levels, and platelets levels in patients of CKD, (3) to do the urine analysis in patients with CKD, and (4) to assess GFR among the study population. Materials and Methods: After taking the informed consent, detailed history was taken and clinical examination of patient was done. Pathological tests such as hemogram, renal function tests, liver function tests, coagulation profile, blood sugar levels, urine routine, and microscopy were performed. Ultrasonography of abdomen and pelvis was done. Correlation was done between severity of sepsis and mortality in patients. Results: Anemia was moderate (7–8.9 g/dl) in 38%, mild (9–10.9 g/dl) in 31%, while severe (<6.9) in 29 patients, that is, 29%. Thrombocytopenia was present in 58% of patients. Mean serum albumin in patients was 2.67±0.551 mg/dl; serum globulin was 3.89±0.345 mg/dl. Mean blood sugar of study subjects was 127.41±61.387 mg/dl fasting, 199.67±114.827 mg/dl post-prandial, and mean glycated hemoglobin was 5.63 ± 1.668. On ultrasound acute pyelonephritis, 25 (25%) was the most common finding. Conclusion: Correlation of clinical findings with pathological and radiological findings is very important in patients with CKD. Severity of sepsis directly correlates with mortality of patients.

Coagulation profile in two nephropathic dogs

Coagulatory abnormalities are common in renal dysfunction in humans. The studies on coagulatory abnormalities in renal failure in dogs are limited. The present paper deals with coagulation profile in acute and chronic kidney disease in dogs. The haemostatic defects observed in acute renal dysfunction included thrombocytopaenia, prolonged capillary bleeding time (CBT), elevated D-Dimer and hypoantithrombinemia which indicated a hypercoagulable state. Prolongation of prothrombin time (PT), activated partial thromboplastin time (aPTT), elevated D-Dimer concentration and hypoantithrombinemia in chronic kidney disease indicated the presence of hypocoagulable state

Simple Coagulation Profile as Predictor of Mortality in Adults Admitted with COVID-19: A Meta-Analysis

Context: COVID-19 severe manifestations must be detected as soon as possible. One of the essential poor characteristics is the involvement of coagulopathy. Simple coagulation parameters, including prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), and platelet, are widely accessible in many health centers. Objectives: This meta-analysis aimed to determine the association between simple coagulation profiles and COVID-19 in-hospital mortality. Method: We systematically searched five databases for studies measuring simple coagulation parameters in COVID-19 on admission. The random-effects and inverse-variance weighting were used in the study, which used a standardized-mean difference of coagulation profile values. The odds ratios were computed using the Mantel-Haenszel formula for dichotomous variables. Results: This meta-analysis comprised a total of 30 studies (9,175 patients). In our meta-analysis, we found that non-survivors had a lower platelet count [SMD = -0.56 (95% CI: -0.79 to -0.33), P < 0.01; OR = 3.00 (95% CI: 1.66 to 5.41), P < 0.01], prolonged PT [SMD = 1.22 (95%CI: 0.71 to 1.72), P < 0.01; OR = 1.86 (95%CI: 1.43 to 2.43), P < 0.01], prolonged aPTT [SMD = 0.24 (95%CI: -0.04 to 0.52), P = 0.99], and increased INR [SMD = 2.21 (95%CI: 0.10 to 4.31), P = 0.04] than survivors. Conclusions: In COVID-19 patients, abnormal simple coagulation parameters on admission, such as platelet, PT, and INR, were associated with mortality outcomes.

Determination of Coagulation Profile among Children with Sickle Cell: Anemia in Steady-State and Crisis

Background: Patients with Sickle Cell Disease (SCD) have been found to have an aberrant coagulation profile. One of the primary elements hypothesized to contribute to the vaso-occlusive crisis that characterizes sickle cell disease is coagulopathy (SCD) Material and Methods: A total of 150 children were enrolled as follows, 50 children with Sickle Cell Anemia (SCA) in steady-state, 50 in crisis, and 50 with Hb AA genotype as control. 5 ml of Venous blood was collected. The platelets count was performed using Sysmex KX21N, the electrical impedance principle. The Mean Platelet Volume (MPV) is derived from the impedance platelet size distribution curve. STAGO PT31039352) semi-automated machine was used for estimation of PT, and APTT. Result: children with SCA have significantly a prolonged PT, and APTT compared with children with normal hemoglobin genotype (P. value < 0.001) the mean of PT was (16.64, and 12.6) respectively, and APTT (41.45 and 37.94) consequently. A significant increase in platelet count between patients with SCA when compared with control (p. value 0.02), however a significant prolonged in APTT when compared to steady-state (P. value 0.005). MPV among children with crises when compared with steady-state revealed a significant result (p. value 0.006) the mean of MPV in steady-state = 6.79 while the mean of MPV in crisis = 7.09. Conclusion: children with sickle cell anemia had a longer coagulation profile and marked variation in platelet count, which may increase the risk of thrombosis or bleeding.

Investigation of the effect of selected edible and medicinal plants on in-vitro blood coagulation profile

Anticoagulation therapy represents a mainstay of treatment and prevention of cardiovascular diseases which are the leading causes of mortality worldwide. In addition, several case reports of spontaneous bleeding occurred linking the consumption of many dietary supplements during treatment with anticoagulants or in postoperative patients. This prompted our study which is conducted on eleven well-known Egyptian medicinal plants to highlight their effect on blood coagulation profile using Prothrombin time (PT) and activated partial thromboplastin time (aPTT) tests. Some of these plants showed interesting results that need more in-depth evaluation of their anticoagulant activity as Hibiscus sabdarifa calyx for its effect on PT. In addition, extracts of Trifolium alexandrinum aerial parts and Pimpinella anismum fruit were proved to affect aPTT. Post operative or cardiovascular patients using herbal supplements should be cautioned about food-drug or herb-drug interactions and to adjust their herbal medication regimen before surgery.

Changes in post-operative renal function and coagulation profile after hydroxyethyl starch administration in patients undergoing orthopedic hip surgery under spinal anesthesia

Background: Hydroxyethyl starch solutions which have been introduced some three decades ago, have been extensively used for treatment of intraoperative hypovolaemia. Aims and Objectives: The present prospective study was conducted to study changes in post-operative renal function and coagulation profile in patients undergoing orthopedic hip surgery under spinal anesthesia after coloading with 6% HES 130/0.4. Materials and Methods: Seventy patients, aged between 50 and 80 years, of either sex, belonging to ASA physical Status I and II, scheduled for orthopedic hip surgery under spinal anesthesia were included in the study. As per the group allocation, coloading was done with 7.5 mlkg-1 of either Group RL or 6% 130/0.4 Group HES during the 1st h of surgery. Venous samples were withdrawn before the day of surgery, on the day of surgery, and on the 3rd day of surgery. Results: No statistically significant difference between renal and coagulation profile was found among groups. Conclusion: Thus, we recommend using tetrastarch (6% HES 130/0.4) for intraoperative hypovolemia in elderly patients with normal renal function and coagulation profile undergoing orthopedic hip surgery.

A cross sectional study of coagulation profile in term normotensive pregnancy and hypertensive disorders like preeclampsia, eclampsia

Background: Normal pregnancy is a procoagulant state. In preeclampsia, this process of coagulation is exaggerated and will lead to further effects on the mother, placenta and fetus. The purpose of this study is to find out the changes that occur in the coagulation indices in pregnancy induced hypertension as compared to that in normal pregnancy which will help in the better management of patients with pregnancy induced Hypertension.Methods: This was a cross sectional study in 116 patients with normotensive and patients with hypertensive disorders in pregnancy conducted in a tertiary medical facility. Coagulation parameters like platelet count, prothrombin time, activated partial thromboplastin time, bleeding time and clotting time were evaluated. We used the difference of 5% in mean PT between normotensive (control) and hypertensive patients by applying 80% power and alpha error of 5%.Results: Platelet counts of study population were significantly related to the prognosis of the patient. The cut off values of major parameters like aPtt, BT with the outcome were with p value of 0.37 and 0.76 respectively.Conclusions: In cases of pregnant complicated with HDP, parameters like coagulation profile, bleeding time, clotting time were probably useful indicators in the early diagnosis and management of severe morbidity of the mother and the fetus. Further prospective trials with large study population are warranted to evident these results.