Evaluation of Some Hemostatic Abnormalities in Chronic Kidney Disease Patients Pre and Post Hemodialysis

Background: Chronic kidney disease and hemodialysis associated with disturbance in hemostasis. Uremic toxins induced platelet dysfunction, coagulopathy, endothelial dysfunction and impaired fibrinolysis. Aim: To evaluate some hemostatic abnormalities in patients with chronic kidney disease before and after hemodialysis. Patients and methods: A case-control study, involving (50) patients with chronic kidney disease on regular hemodialysis admitted to Ibn-Sina Teaching Hospital in Mosul city between April to September 2025, and (30) healthy controls. The sample underwent hemostatic investigations (pre and post hemodialysis) including: prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, factor VIII, and Von Willebrand factor. Results: The mean age was 50.96 years, including 66% male and 34% female, the M: F ratio is 1.9: 1. The mean of prothrombin time (after hemodialysis), activated partial thromboplastin time, fibrinogen, D-dimer, factor VIII and von Willebrand factor were significantly higher in patients with chronic kidney disease in comparison to control. The mean of prothrombin time, activated partial thromboplastin time, D-dimer, and factor VIII after hemodialysis were significantly higher than before hemodialysis with P-value of (0.000), (0.032), (0.040) and (0.002) respectively. There was statistically significant direct correlation between prothrombin time and glomerular filteration rate before dialysis (r= -283, p=0.046). There was negative statically significant correlation between activated partial thromboplastin time before dialysis with factor VIII (r=-0.502, p=0.000). Conclusions: the current study concluded that the hemostatic markers were further increased after hemodialysis, which increased risk of bleeding and thromboembolic events.