Thrombosis and Bleeding Risk in Chronic Kidney Disease: Hematologic Alterations, Pathophysiology, and Management Strategies

Background Chronic kidney disease (CKD) is associated with altered hemostasis, leading to both thrombosis and bleeding risks. Objective This study aimed to investigate hematologic alterations in CKD patients, focusing on coagulation factor and platelet abnormalities, and their role in thrombosis and bleeding risk. Methods In this cross-sectional observational study, 120 adult patients with CKD were enrolled. Data on demographic characteristics, comorbidities, and laboratory values were collected. Blood samples were analyzed for coagulation factors (Factors II, V, VII, VIII, IX), fibrinogen levels, and platelet function using standard assays. Thrombosis and bleeding risks were assessed based on thrombin generation assays and clinical records. Statistical analyses, including ANOVA, Pearson’s correlation, logistic regression, and ROC curve analysis, were performed to explore associations between hematologic parameters and clinical outcomes. Results Coagulation factor levels varied significantly across different CKD stages, with decreased levels of Factors II, V, VII, and VIII associated with increased bleeding risk. Platelet dysfunction was observed, with impaired aggregation in advanced stages of CKD. Thrombosis risk was significantly elevated in patients with altered coagulation profiles. Logistic regression identified low levels of coagulation factors and platelet dysfunction as independent predictors of increased thrombosis and bleeding risk. Conclusion Hematologic alterations, including changes in coagulation factors and platelet dysfunction, contribute significantly to thrombosis and bleeding risks in CKD patients. Regular monitoring of these factors is essential for managing hemostatic imbalances in CKD.