Original Article This work is licensed under the Creative Commons Attribution 4.0 License. Published by Pacifc Group of e-Journals (PaGe) Impact of Haemodialysis on Coagulation Profle in Chronic Kidney Disease Introduction Chronic kidney disease (CKD) is a global health problem, with a very high cost of care and a great burden particularly in developing countries like India. The Kidney Disease Outcomes Quality Initiative describes 5 stages of CKD, with the Stage 5 being End Stage Renal Disease (ESRD) which is characterized by progressive, irreversible deterioration in the renal function and the body failing to maintain fuid and electrolyte balance resulting in uraemia [1] . In CKD both bleeding and thrombotic complications are observed mainly because of disturbed balance between pro and anti-haemostatic factors, leading to high morbidity and mortality [2] . Due to the high cost and difculty in fnding a compatible organ donor associated with transplantation, dialysis remains as one of the most common modalities of RRT worldwide [3] . Haemodialysis (HD) results in alterations of platelet function and changes in both coagulation and fbrinolytic systems. Platelets have been well-known to interact with dialysis membranes since the 1970’s; dialysis membranes have been shown to cause platelet adhesion, aggregation, and activation [4] . Thrombotic events result from variations in vessel wall integrity, platelet activation and reduced blood fow into the fstula used to access the vessel. Hypercoagulability states are associated with cerebral spill, cardiac disease and pulmonary embolism. Both PT (Prothrombin time) and aPTT (activated Partial Thromboplastin time) tend to increase post dialysis. In cases where fstulas of polytetrafuorethylene (PTFE) is used, increased coagulation has a risk for thrombus formation in vascular access for dialysis [5] . The aim of the study is to fnd out the variations in platelet count, PT, International Normalised Ratio (INR) and aPTT before and after HD. The present study might help the clinicians to initiate proper precautions before and after the dialysis procedures. Materials & Methods This prospective observational study of coagulation profle and platelet count in pre and post hemodialysis patients with chronic renal failure was conducted in the Department of Pathology in collaboration with the Department of Nephrology, SRM Medical College Hospital & Research Centre and approved by our Institutional Ethical Committee. A total of 150 patients diagnosed as CKD and subjected for hemodialysis were included in this study. An informed consent was obtained from all the subjects. Hematological Veena Raja 1 *, Shivashekar Ganapathy 1 , Suresh Kumar Karthikean 2 and Pradhiksha Das Prakash 2 1 Department of Pathology, SRM Medical College Hospital and Research Centre, SRM IST, Potheri, Chengalpattu - 603203 2 Department of Forensic Medicine, ACS Medical College and Hospital, Chennai - 600077 ABSTRACT Background: Chronic kidney disease (CKD) with its high prevalence, morbidity and mortality is an important public health problem. Considering the nature of the haemodialysis process, it has a considerable impact on the coagulation profle. To fnd out the variations in Platelet count, Prothrombin time (PT), International Normalised Ratio (INR) and Activated Partial Thromboplastin Time (aPTT) before and after haemodialysis patients. Materials and Methods: This prospective observational study of Coagulation profle and platelet count in pre and post hemodialysis patients with chronic renal failure was conducted on 150 CKD patients in the Department of Pathology, SRM Medical College Hospital & Research Centre. p value <0.05 was considered to be statistically signifcant. Results: In this study, there was signifcant reduction in platelet count from mean 2.29 cells/cu.mm in pre dialysis to 2.03 cell/cu.mm in post dialysis. There was a signifcant prolongation in both PT and aPTT values in post dialysis Conclusion: These fndings expose CKD patients to higher risk of bleeding disorders, which may have a role in increasing the rate of patient mortality and morbidity. In the light of this study, there is a need for nephrologist to monitor the coagulation profle and platelet count of CKD patients on dialysis, and treat any derangements in the same, so as to improve outcome for these patients. Keywords: Chronic Kidney Disease, Coagulation Profile, Hemodialysis, Bleeding Disorders, Thrombocytopenia DOI: 10.21276/APALM.3015