@article {2412, title = {Abnormalities in Hemostatic Parameters Related to Hemodialysis in End-stage Kidney Pathology: A Narrative Review}, journal = {Pharmacognosy Journal}, volume = {16}, year = {2024}, month = {October 2024}, pages = {1223-1230}, type = {Review Article}, chapter = {1223}, abstract = {

Chronic kidney disease (CKD) is a progressively prevalent global health issue. During the initial phases of the condition, CKD is commonly linked to a tendency for excessive blood clotting. While in the end-stage of disease, patients undergoing hemodialysis have a multitude of hemostatic abnormalities. These include prolonged bleeding time, altered platelet count, prolonged PT and aPTT, elevated FDPs and D-dimer, dysregulated vWF activity, and abnormal thrombin generation. These changes result from a combination of uremic toxicity, endothelial dysfunction, inflammatory states, and the effects of the hemodialysis procedure itself. Understanding these mechanisms is crucial for managing and mitigating the bleeding and thrombotic risks in this patient population. This review aims to systematically investigate the effects of hemodialysis on key hemostasis parameters in CKD patients.

}, keywords = {Coagulation, End-stage Kidney Disease (ESKD), Hemodialysis, Hemostasis}, doi = {10.5530/pj.2024.16.200}, author = {Bassam A. Hazae and Yetti Hernaningsih and Puspa Wardhani and Fatima Albadwi and Nastasya Nunki} } @article {2437, title = {Natural Compounds in Clot Waveform Analysis and D-Dimer Modulation: Implications for COVID-19 Diagnosis and Prognosis}, journal = {Pharmacognosy Journal}, volume = {16}, year = {2024}, month = {December 2024}, pages = {1373-1378}, type = {Research Article}, chapter = {1373}, abstract = {

Objectives: Patients diagnosed with coronavirus disease (COVID-19) may develop hypercoagulopathy. A thromboelastogram can detect hypercoagulopathy, but it is not commonly available in all healthcare facilities. Understanding the clot waveform analysis (CWA) parameters of the CS-2500 coagulation analyzer in patients diagnosed with COVID-19 may help determine whether it can serve as an alternative. Methods: This study measured the amounts of activated partial thromboplastin time (aPTT)-based CWA, aPTT, plasma prothrombin time (PPT), and D-dimer using the CS-2500 autoanalyzer in 177 patients confirmed with COVID-19 and 110 patients without COVID-19. Retrospective data collection was conducted using electronic medical records. COVID-19 and non-COVID-19 were distinguished by the SARS-COV-2 PCR results. Results: Substantial differences were observed in the aPTT-based CWA parameters, including maximum coagulation velocity (Vmax), maximum coagulation acceleration (Amax), and maximum coagulation deceleration (Dmax) (p = 0.03, p = 0.03, and p = 0.02), between the COVID-19 and non-COVID-19 groups but not between survivors and non-survivors. Additionally, a substantial difference was identified in the D-dimer between the two groups (p = 0.002 and p \< 0.001). The difference in D-dimer between both groups could be explained by the fact that non-survivors have a more prominent hypercoagulable state. Conclusions: While the D-dimer may be a better indicator of mortality in COVID-19 patients, the aPTT-based CWA characteristics may be more helpful in differentiating between COVID-19 and non-COVID-19 patients. Further investigations on treatment interference and the specificity of this method to predict hypercoagulable states are warranted.

}, keywords = {Activated partial thromboplastin time, Clot waveform analysis, COVID-19, D-dimer}, doi = {10.5530/pj.2024.16.221}, author = {Prafa Alif Rahmawan and Yetti Hernaningsih} }