Does the Density of a Blood Clot Increase the Risk for Mortality?

A new study found that the density of a blood clot structure may be an important risk factor for mortality in patients on hemodialysis.

Researchers used an turbidmetric assay to examine the fibrin clot structure parameters and mortality in 171 patients on chronic hemodialysis. The Kaplan-Meier estimator, and multivariate Cox regression models were used to analyze the density and risk factors of blood clots in patients.
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In addition, researchers compared purified fibrinogen from healthy controls to patients on hemodialysis, and investigated the differences using the calcium-dependent 1F-1mAb, mass spectrometric analysis, and electron microscopy.

According to the Kaplan-Meier analysis, denser clot structures increased all-cause and cardiovascular mortality risks in patients on hemodialysis. The denser clots were confirmed to exist independently of other risk factors by the Cox regression models, which adjusted for age, diabetes, sex, duration of dialysis, duration of fibrinogen, C-reactive protein, and complement C3.

In the comparison between fibrinogens, researchers found that fibrinogen in patients on hemodialysis was glycosylated and guanidinylated, but the healthy controls had no post-translational modifications. Likewise, clots made from the patients on hemodialysis had significantly thinner fibers than clots made from the healthy control fibrinogen.

“In vitro guanidinylation of fibrinogen from healthy subjects increased the formation of thinner fibers, suggesting that difference in fiber thickness might be at least partially due to post-translational modifications,” the researchers stated.

The findings suggest that denser clot structures may be a crucial risk factor for mortality in patients on hemodialysis.  

—Melissa Weiss

Reference:

Schuett K, Savvaidis A, Maxeiner S, et al. Clot Structure: A Potent Mortality Risk Factor in Patients on Hemodialysis [published online before print January 5, 2017]. Journal of the American Society of Nephrology. doi:10.1681/ASN.2016030336.