Lupus-Like in vitro Anticoagulant Activity in End-Stage Renal Disease

Abstract

Lupus-like anticoagulant is diagnosed by a prolonged activated plasma thromboplastin time not corrected after incubation with normal plasma, prolongation of diluted tissue thromboplastin time and of diluted Russel''s viper venom time, excluding factor deficiencies or specific coagulation inhibitors. We studied the presence of this ''lupus-like anticoagulant'' in 100 patients with end-stage renal disease, 56 on hemodialysis and 44 on conservative treatment. ''Lupus-like anticoagulant'' activity was found in vitro in the blood of 22 patients (22%) being a significantly higher prevalence than that found in 125 patients with systemic lupus erythematosus (15%) and in 50 healthy controls (0%). Hemodialysis patients showed ''lupus-like antiboagulant'' activity in 30% cases, compared to 11% patients on conservation treatment. The presence of ''lupus-like anticoagulant'' was unrelated with primary disease or medication received. The incidence of thrombosis in patients with this in vitro anticoagulant was higher than in patients without it (23 vs. 13%), although this difference is not significant. We conclude that prevalence of ''lupus-like anticoagulant'' is high in patients with end-stage renal disease, a previously unreported observation. Its clinical and pathogenetic significance should be studied further.