2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2004110999v1 16/4/1108    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Knoll, G. A. Articles by Rodger, M. A. Search for Related Content PubMed PubMed Citation Articles by Knoll, G. A. Articles by Rodger, M. A.

Thrombophilia and the Risk for Hemodialysis Vascular Access Thrombosis

Greg A. Knoll^*,,, Philip S. Wells^,, Darlene Young, Sherry L. Perkins^||, Rachel M. Pilkey^¶, Jennifer J. Clinch and Marc A. Rodger^,

Divisions of ^* Nephrology; Hematology, Department of Medicine, University of Ottawa, Kidney Research Centre and Clinical Epidemiology Program, The Ottawa Health Research Institute, and ^|| Department of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario; and ^¶ Division of Nephrology, Department of Medicine, Queens University, Kingston, Ontario, Canada

Address correspondence to: Dr. Greg A. Knoll, Division of Nephrology, The Ottawa Hospital, Riverside Campus, 1967 Riverside Drive, Ottawa, Ontario, Canada K1H 7W9. Phone: 613-738-8400 ext. 82536; Fax: 613-738-8337; gknoll{at}ottawahospital.on.ca

Received for publication November 24, 2004. Accepted for publication January 17, 2005.

Vascular access thrombosis is the most common and costly complication in hemodialysis patients. The role of thrombophilia in access thrombosis is not established. A case-control study was conducted of 419 hemodialysis patients to determine whether thrombophilia was associated with arteriovenous fistula or graft thrombosis. Participants were enrolled from three in-center and five satellite dialysis units associated with a Canadian academic health science center that provides dialysis services in a catchment area of one million. Patients were tested for factor V Leiden, prothrombin gene mutation, factor XIII genotype, methylenetetrahydrofolate reductase genotype, lupus anticoagulant, anticardiolipin antibody, factor VIII, homocysteine, and lipoprotein (a) concentrations. Overall, 59 (55%) patients with access thrombosis had at least one thrombophilia compared with 122 (39%) patients without access thrombosis (unadjusted odds ratio [OR], 1.91; 95% confidence interval [CI], 1.23 to 2.98). After controlling for important risk factors, the association between any thrombophilia and access thrombosis remained (adjusted OR, 2.42; 95% CI, 1.47 to 3.99). For each additional thrombophilic disorder, the odds of access thrombosis increased significantly (adjusted OR, 1.87; 95% CI, 1.34 to 2.61). This study suggests that thrombophilia is associated with access thrombosis in dialysis patients. Large, multicenter, prospective cohort studies are needed to confirm the observations from this case-control study.

This article has been cited by other articles:

				A. Lazo-Langner, G. A. Knoll, P. S. Wells, N. Carson, and M. A. Rodger The risk of dialysis access thrombosis is related to the transforming growth factor-beta1 production haplotype and is modified by polymorphisms in the plasminogen activator inhibitor-type 1 gene Blood, December 15, 2006; 108(13): 4052 - 4058. [Abstract] [Full Text] [PDF]

				P. L. Bockenstedt Management of Hereditary Hypercoagulable Disorders Hematology, January 1, 2006; 2006(1): 444 - 449. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673