Abstract: PUB456
Cellular Indices in Relation to D-dimer and Thrombin Levels in Patients with ESKD
Session Information
Category: Pathology and Lab Medicine
- 1800 Pathology and Lab Medicine
Authors
- Hussain, Hamzah, Loyola University Medical Center, Chicago, Illinois, United States
- Siddiqui, Fakiha, Loyola University Medical Center, Chicago, United States
- Hoppensteadt, Debra, Loyola University Medical Center, Chicago, Illinois, United States
- Abulencia, Emma, Loyola University Medical Center, Chicago, Illinois, United States
- Fairand, Elyse, Loyola University Medical Center, Chicago, Illinois, United States
- Fareed, Jawed, Loyola University Medical Center, Chicago, Illinois, United States
- Bansal, Vinod K., Loyola University Medical Center, Chicago, Illinois, United States
Background
End-stage renal disease (ESRD) is often associated with thromboinflamatory complications. Besides the biomarkers of thrombin generation such as D-Dimer (DD) and peak thrombin (PT) levels, cellular indicies (CI's) have been reported to change with the severity of ESRD. Such CI's as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune-inflammation index (SII), lymphocyte to monocyte ratio (LMR), neutrophil to monocyte ratio (NMR) and their relevance with biomarkers such as DD and PT were profiled in ESRD patients.
Methods
Citrated plasma samples from patients with confirmed ESRD were collected in the Hemodialysis Clinic at Loyola University Medical Center. 50 healthy plasma samples served as control. Commercially available sandwich ELISA methods were used for DD levels, and PT was quantified by using a fluorogenic method. Blood CI's were extracted from complete blood counts. Applicable statistical methods were performed and p<0.05 were considered significant.
Results
The ESRD group comprised 56.9% males and 43.1% females, with a median age of 66 years. Comparing controls to ESRD cohort, DD increased significantly from 7.1 to 905.8ng/mL (p<0.05) while PT levels decreased from 138.4 to 109.9nM (p<0.05). NLR increased from 1.6 to 3.4, SII increased from 444.5 to 583.2, and LMR decreased from 4.1 to 2.4 (p<0.05). PLR and NMR showed no significant difference. Table 1 represents the composite results. There was no correlation between DD and PT. There were varying degrees of correlation between cellular indicies.
Conclusion
These studies suggest that beside thromboinflmatory biomarkers, CI's may provide additional prognostic parameters in the risk stratification of ESRD. All of the CI's included in this study are increased except for LMR. CI's represent an emerging tool to risk stratify ESRD patients.
Table 1
| Biomarker or CI | Controls Median (Range) | ESRD Median (Range) | p-value |
| DD (ng/ml) | 7.1 (7.1-696.5) | 905.8 (79.3-6385.1) | <0.05 |
| PT (nM) | 138.4 (81.3-224.3) | 109.9 (0.0-245.4) | <0.05 |
| NLR | 1.6 (0.8-13.3) | 3.4 (1.3-9.0) | <0.05 |
| PLR | 131.6 (58.8-1966.7) | 138.3 (2.2-344.0) | 0.51 |
| SII | 444.5 (186.7-1573.3) | 583.2 (10.5-2424.0) | <0.05 |
| LMR | 4.1 (1.0-14.5) | 2.4 (0.4-19.0) | <0.05 |
| NMR | 7.0 (2.3-39.0) | 7.1 (2.8-48.0) | 1.00 |