Thromboelastographic Profile of Patients with Hyperparathyroidism Secondary to Chronic Kidney Failure Submitted to Total Parathyroidectomy

DOI: 10.4236/ojanes.2013.38077   PDF   HTML     4,137 Downloads   5,911 Views   Citations

Abstract

Coagulopathy in surgical patients can cause perioperative complications, as both bleeding and thromboembolic events increase surgical morbimortality. The recognition of preexisting disorders and the understanding of the dynamic changes in hemostasis during surgery are prerequisites of safe patient management. The perioperative management of patients with chronic kidney failure is a huge challenge due to both the hypercoagulable state and increased risk of bleeding. Classic laboratory exams performed for the evaluation of blood clotting seem insufficient regarding the determination of the risk of bleeding and thrombosis in surgical patients. As patients with chronic kidney failure develop secondary hyperparathyroidism, the aim of the present study was to describe a case series and correlate the perioperative thromboelastographic profile of patients with chronic kidney failure submitted to parathyroidectomy with their secondary hyperparathyroidism.

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W. Boas, C. Oliveira, T. Máximo, C. Trindade and A. Sousa, "Thromboelastographic Profile of Patients with Hyperparathyroidism Secondary to Chronic Kidney Failure Submitted to Total Parathyroidectomy," Open Journal of Anesthesiology, Vol. 3 No. 8, 2013, pp. 363-366. doi: 10.4236/ojanes.2013.38077.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] P. Innerhofer and J. Kienast, “Principles of Perioperative Coagulopathy,” Best Practice & Research Clinical Anaesthesiology, Vol. 24, No. 1, 2010, pp. 1-14.
http://dx.doi.org/10.1016/j.bpa.2009.09.006
[2] E. G. Pivalizza, D. C. Abramson and A. Harvey, “Perioperative Hypercoagulability in Uremic Patients: A Viscoelastic Study,” Journal of Clinical Anesthesia, Vol. 9, No. 6, 1997, pp. 442-5.
http://dx.doi.org/10.1016/S0952-8180(97)00097-4
[3] W. E. Dager and T. H. Kiser, “Systemic Anticoagulation Considerations in Chronic Kidney Disease,” Advances in Chronic Kidney Disease, Vol. 17, No. 5, 2010, pp. 420-427. http://dx.doi.org/10.1053/j.ackd.2010.06.002
[4] M. J. Adams, A. B. Irish and G. F. Watts, et al., “Hypercoagulability in Chronic Kidney Disease Is Associated with Coagulation Activation But Not Endothelial Function,” Thrombosis Research, Vol. 123, No. 2, 2008, pp. 374-380. http://dx.doi.org/10.1016/j.thromres.2008.03.024
[5] R. G. Craig and J. M. Hunter, “Recent Developments in the Perioperative Management of Adult Patients with Chronic Kidney Disease,” British Journal of Anaesthesia, Vol. 101, No. 3, 2008, pp. 296-310.
http://dx.doi.org/10.1093/bja/aen203
[6] D. Bischof, S. Dalbert, A. Zollinger, et al., “Thrombelastography in the Surgical Patient,” Minerva Anestesiologica, Vol. 76, No. 2, 2010, pp. 131-137.
[7] J. L. Kashuk, E. E. Moore, A. Sabel, et al., “Rapid Thrombelastography (r-TEG) Identifies Hypercoagulability and Predicts Thromboembolic Events in Surgical Patients,” Surgery, Vol. 146, No. 4, 2009, pp. 764-772.
http://dx.doi.org/10.1016/j.surg.2009.06.054
[8] C. Erem, M. Kocak, I. Nuhoglu, et al., “Increased Plasminogen Activator Inhibitor-1, Decreased Tissue Factor Pathway Inhibitor, and Unchanged Thrombin-Activatable Fibrinolysis Inhibitor Levels in Patients with Primary Hyperparathyroidism,” European Journal of Endocrinology, Vol. 160, No. 5, 2009, pp. 863-868.
http://dx.doi.org/10.1530/EJE-09-0069
[9] D. Trainor, E. Borthwick and A. Ferguson, “Perioperative Management of the Hemodialysis Patient,” Seminars in Dialysis, Vol. 24, No. 3, 2011, pp. 314-326.
http://dx.doi.org/10.1111/j.1525-139X.2011.00856.x
[10] K. Wattanakit, M. Cushman, C. Stehman-Breen, et al., “Chronic Kidney Disease Increases Risk for Venous Thromboembolism,” Journal of the American Society of Nephrology, Vol. 19, No. 1, 2008, pp. 135-140.
http://dx.doi.org/10.1681/ASN.2007030308

  
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