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Unless sufficient anticoagulation is used during HD, clotting may appear. The objective was to investigate if levels of fibrin degradation products (D-dimer) were increased before and during HD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The combined observational study included 20 patients performing a total of 60 hemodialysis divided into three sessions of low-flux dialysis. None of the patients suffered from any clinically evident thromboembolic event before or during the study. Median bolus anticoagulation (mainly tinzaparin) doses were 84 Units\/kg bow. Blood samples were drawn before HD (predialysis), and at 30min and 180min during HD with focus on analyzing D-dimer levels and its relation to interdialytic weight gain (IDWG) and speed of fluid elimination by HD (UF-rate).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Predialysis, D-dimer levels (mean 0.767 \u00b10.821, min 0.136mg\/L) were above the upper reference value in 95% of the sessions. D-dimer levels were lowered at 30min (<jats:italic>p<\/jats:italic>&lt;0.001) and returned to predialysis levels at 180min. Predialysis D-dimer correlated with NT-pro-BNP, Troponin T, IDWG and UF-rate. Multiple regression analysis revealed that the D-dimer levels were significantly related to IDWG and the UF-rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>D-dimer levels were elevated in a high proportion predialysis and during HD and related to the IDWG and the UF-rate. Awareness of D-dimer levels and future studies will help clarify if optimization of those variables, besides anticoagulation and biocompatibility measures, will eradicate the repeated subclinical thromboembolic events related to each HD; one reason that may explain organ damage and shortened life span of these patients.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12882-024-03654-3","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T15:01:51Z","timestamp":1720796511000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Hemodialysis patients have signs of a chronic thrombotic burden"],"prefix":"10.1186","volume":"25","author":[{"given":"Bernd G.","family":"Stegmayr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lennart D.","family":"Lundberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"issue":"10","key":"3654_CR1","doi-asserted-by":"publisher","first-page":"1953","DOI":"10.1111\/jth.14254","volume":"16","author":"G Ocak","year":"2018","unstructured":"Ocak G, Noordzij M, Rookmaaker MB, Cases A, Couchoud C, Heaf JG, Jarraya F, De Meester J, Groothoff JW, Waldum-Grevbo BE, et al. 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