The Impact of Haemodialysis and Age-related Changes on Coagulation Parameters among Patients with Chronic Kidney Disease (CKD) Attending a Dialysis Centre in Southern Nigeria

Abstract

Chronic kidney disease (CKD) is a major global public health challenge, affecting hundreds of millions of adults worldwide. The Global Burden of Disease 2023 study estimated that approximately 788 million adults aged 20 years and older were living with CKD in 2023. This study evaluated the impact of haemodialysis on some coagulation parameters among patients with chronic kidney disease (CKD) attending a dialysis centre in Southern Nigeria. Out of the one hundred and seventy (170) subjects recruited for the study, seven (7) subjects died after pre-dialysis sample collection, and the remaining one hundred and sixty-three (163) were subsequently grouped following age ranges: 18–39, 40–59, 60–69, 70–79, and ≥80 years. Data obtained from this study were entered and analysed using SPSS version 25. Continuous variables, including coagulation parameters, were presented as mean ± standard deviation (Mean ± SD). For the comparison of the overall CKD patient population, paired t-tests were used to determine statistically significant differences for pre- and post-haemodialysis parameters. To assess age-related variations in coagulation parameters, a one-way analysis of variance (ANOVA) was performed across the defined age groups, while, a post-hoc analysis using the Waller–Duncan test was conducted to identify the specific age groups that differed significantly. A p<0.05 was considered statistically significant for all analyses. There was no significant difference in prothrombin time, activated partial thromboplastin time and international normalised ratio between the pre and post-dialysis subjects across all age groups (P>0.05). The prothrombin time(PT) shortened slightly from 14.01 ± 1.75seconds pre-dialysis to 13.90 ± 1.64seconds post-dialysis (Δ −0.11 s), APTT shortened from 34.94 ± 5.53 s to 34.70 ± 5.63 s (Δ −0.24 s), and INR remained essentially unchanged at 1.19 ± 0.18 pre-dialysis and 1.19 ± 0.17 post-dialysis. None of these changes were statistically significant (PT: t = 0.558, p = 0.577; APTT: t = 0.394, p = 0.694; INR: t = 0.211, p = 0.833), indicating that haemodialysis did not markedly alter coagulation status in the studied cohort.