The following is a summary of “In-vitro influence of urea concentration on thromboelastrography in patients with and without end-stage renal disease,” published in the December 2023 issue of Surgery by Kukreja, et al.
End-stage renal disease (ESRD) is linked to platelet dysfunction and thromboembolic complications, but the role of increased blood urea nitrogen (BUN) in coagulation remains unclear. For a study, researchers sought to characterize thromboelastography (TEG) parameters in males and females with ESRD compared to those with normal kidney function and assess whether exogenous urea in vitro could replicate these TEG differences.
Blood samples were obtained from 20 living kidney donors and 20 kidney recipients. TEG was conducted without and with two escalating urea concentrations in vitro. TEG parameters were compared between recipients and donors.
Kidney recipients exhibited baseline increases in maximum amplitude (MA) and shortened time to maximum amplitude (TMA) compared to donors, with these differences not observed in females. In all patients, BUN inversely correlated with TMA (r = −0.342; P = 0.031). BUN and creatinine concentrations in males were directly correlated with MA (0.583; P = 0.007) and inversely correlated with TMA (r = −0.520; P = 0.019). Urea in vitro decreased R-time (P = 0.005) and increased LY30 (P = 0.009) in donors but not recipients.
ESRD is linked to increased MA and decreased TMA on TEG. However, increasing urea concentrations in vitro did not alter MA. Gender-specific variations in TEG parameters were also observed.
Reference: americanjournalofsurgery.com/article/S0002-9610(23)00278-7/abstract