Effect of a Single Hemodialysis Session on Hemostatic Function in Patients With Chronic Kidney Disease

Chronic kidney disease (CKD) is associated with complex disturbances in hemostasis that may increase susceptibility to both bleeding and thrombotic complications. Hemodialysis, an essential treatment for advanced CKD, may further influence hematological and coagulation measurements through extracorporeal blood circulation, fluid removal, and anticoagulation. This observational study assessed changes in selected hematological and coagulation parameters immediately before and after a single hemodialysis session. Thirty-two patients receiving maintenance hemodialysis at Al-Fallujah Teaching Hospital were enrolled, and paired blood specimens were analyzed using complete blood count measurements and routine coagulation assays, including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, and D-dimer. Most hematological comparisons were based on 31 paired measurements, whereas coagulation parameters were available for 32 participants. WBC and neutrophil counts, RBC count, hemoglobin, and hematocrit showed statistically significant post-dialysis increases in the reported analyses. Platelet count and routine platelet indices showed no significant differences. PT and APTT decreased slightly, while fibrinogen and D-dimer increased modestly; none of these coagulation differences reached statistical significance. These results suggest that one hemodialysis session is associated with selective short-term changes in circulating blood-cell measurements, whereas conventional coagulation indices remained relatively stable in this small cohort. Larger studies that document anticoagulation, fluid removal, and additional measures of platelet and coagulation function are warranted to clarify the mechanisms and clinical relevance of these findings.