Coagulation and fibrinolysis in patients with chronic renal failure on maintenance hemodialysis.

Alteration of the coagulation-fibrinolysis system was examined in patients on maintenance hemodialysis. The mean values of fibrinogen, factor V, factor VII, factor VIII, vWF (activity and antigen), factor IX and factor XI were significantly higher in these patients than in control subjects (p less than 0.01), but factor XII alone was significantly lower. Fibrinolytic parameters (euglobulin lysis time, fibrin plate lysis, fibrin degradation products and alpha 2-plasmin inhibitor-plasmin complex) suggested a hyperfibrinolytic state and plasmin generation in the patients' circulation. These findings suggest that the alteration of the coagulation-fibrinolysis system is aggravated by repeated hemodialysis, either by the influence of the dialyzer itself or heparin.