PB1012 - Thromboelastography Analysis in Pre- and Post-Hemodialysis Chronic Kidney Disease Patients at the Hemodialysis Unit of Dr. Soetomo General Academic Hospital Surabaya

Background: Hemodialysis is a renal replacement procedure for CKD patients, is believed to partially improve coagulopathy. Thromboelastography (TEG) is a Point Of Care Testing (POCT) tool used for rapid assessment of coagulation and fibrinolysis processes. TEG along with the fibrinogen level and D-Dimer can asses the hemostatic profile in CKD patients who underwent hemodialysis.

Aims: To asses differences in TEG results (R time, K time, MA, alpha angle and LY30), fibrinogen dan D-Dimer levels between pre and post hemodialysis.

Methods: A pre-experimental study with 15 CKD patients examined for hemostasis profiles using TEG, fibrinogen, and D-Dimer levels in both pre and post hemodialysis procedure. Conducted from August to December 2023 at Dr. Soetomo General Academic Hospital. Statistical analysis used paired t-tests and Wilcoxon tests.

Results: Hypercoagulable state observed in CKD patients pre and post hemodialysis. The mean age was 51 years old. There was a significant difference in R time with p value 0.03, indicating coagulation activation due to hemodialysis—possibly from blood-dialyzer membrane contact and rapid thrombin formation. No difference in K time, alpha angle, MA, and LY30 parameters with p value 0.0887, 0.496, 0.82, 0.177, consecutively. No difference in fibrinogen and D-Dimer levels (p=0.399, 0.776). The complete interpretation were made by the hematologist to interpret the TEG based on the graphs and all the parameters.

Conclusion(s): Only R time value differs in TEG examination pre and post hemodialysis in CKD patients. A holistic evaluation using information TEG to interpret the hemostatic condition of CKD patient is needed to determine the coagulopathy coagulopathy status both in pre and post HD.