Extracorporeal Detoxification Methods and Hemostasis System for Ovarian Cancer Patients. Clinical Case

Introduction. Malignant tumors dominate in the picture of disability and mortality worldwide. One of the most frequent and dangerous comorbid conditions is kidney injury. At the same time, the most unfavorable incidence of acute kidney injury is recorded in multiple myeloma, leukemia, lymphoma and k...

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Main Authors: A. S. Safonov, M. V. Zabelin, A. A. Izmailov, Z. A. Valiullina, A. R. Mukhametkulova, A. V. Vasilchenko, K. N. Zolotukhin
Format: Article
Language:English
Published: Bashkir State Medical University 2023-07-01
Series:Креативная хирургия и онкология
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Online Access:https://www.surgonco.ru/jour/article/view/814
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author A. S. Safonov
M. V. Zabelin
A. A. Izmailov
Z. A. Valiullina
A. R. Mukhametkulova
A. V. Vasilchenko
K. N. Zolotukhin
author_facet A. S. Safonov
M. V. Zabelin
A. A. Izmailov
Z. A. Valiullina
A. R. Mukhametkulova
A. V. Vasilchenko
K. N. Zolotukhin
author_sort A. S. Safonov
collection DOAJ
description Introduction. Malignant tumors dominate in the picture of disability and mortality worldwide. One of the most frequent and dangerous comorbid conditions is kidney injury. At the same time, the most unfavorable incidence of acute kidney injury is recorded in multiple myeloma, leukemia, lymphoma and kidney and/or liver cancer and malignant ovarian neoplasms. In this regard, of vital importance is the choice of tactics in the prevention of thrombosis and thromboembolic complications, as well as the individual approach to of the anticoagulant therapy regimen during renal replacement therapy sessions, depending on the underlying disease and the state of the hemostatic system.   Aim. To evaluate the effect of calcium citrate veno-venous hemodiafi ltration sessions on the hemostatic system of a patient with progressive organ dysfunctions associated with malignant ovarian neoplasm.   Materials and methods. The methodology involved literature review and a case study to assess the effect of veno-venous hemodiafi ltration on hemostasis.   Results and discussion. The clinical case was assessed in terms of P-selectin (CD62), which characterizes platelet activation processes. It should be noted that in this patient, the expression of P-selectin increased with each session of renal replacement therapy, while the platelet aggregation values remained at the level of the lower thresholds, which indicates a low probability of coagulation initiation. However, due to aggressive regulation of ovarian cancer by the hemostatic system in the form of production of inflammatory mediators, microvesicles, tissue factor expression and endothelial activation, attention should be paid to the molecular aspects of platelet activation in renal replacement therapy with regional citrate coagulation.   Conclusion. The widespread use of extracorporeal detoxification methods is an independent risk factor not only for bleeding events, but may potentially contribute to thrombosis and thromboembolic complications, which requires a further detailed study of molecular mechanisms of hemostasis regulation by tumor and clinical evaluation of various anticoagulation methods.
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spelling doaj-art-d8adcbc25aea42dd8e9eaa759a52f8cc2025-08-20T03:57:27ZengBashkir State Medical UniversityКреативная хирургия и онкология2076-30932307-05012023-07-0113216517010.24060/2076-3093-2023-13-2-165-170530Extracorporeal Detoxification Methods and Hemostasis System for Ovarian Cancer Patients. Clinical CaseA. S. Safonov0M. V. Zabelin1A. A. Izmailov2Z. A. Valiullina3A. R. Mukhametkulova4A. V. Vasilchenko5K. N. Zolotukhin6Bashkir State Medical UniversityBashkir State Medical UniversityBashkir State Medical UniversityBashkir State Medical UniversityBashkir State Medical UniversityUfa Law Institute of the Ministry of Internal Aff airs of RussiaBashkir State Medical UniversityIntroduction. Malignant tumors dominate in the picture of disability and mortality worldwide. One of the most frequent and dangerous comorbid conditions is kidney injury. At the same time, the most unfavorable incidence of acute kidney injury is recorded in multiple myeloma, leukemia, lymphoma and kidney and/or liver cancer and malignant ovarian neoplasms. In this regard, of vital importance is the choice of tactics in the prevention of thrombosis and thromboembolic complications, as well as the individual approach to of the anticoagulant therapy regimen during renal replacement therapy sessions, depending on the underlying disease and the state of the hemostatic system.   Aim. To evaluate the effect of calcium citrate veno-venous hemodiafi ltration sessions on the hemostatic system of a patient with progressive organ dysfunctions associated with malignant ovarian neoplasm.   Materials and methods. The methodology involved literature review and a case study to assess the effect of veno-venous hemodiafi ltration on hemostasis.   Results and discussion. The clinical case was assessed in terms of P-selectin (CD62), which characterizes platelet activation processes. It should be noted that in this patient, the expression of P-selectin increased with each session of renal replacement therapy, while the platelet aggregation values remained at the level of the lower thresholds, which indicates a low probability of coagulation initiation. However, due to aggressive regulation of ovarian cancer by the hemostatic system in the form of production of inflammatory mediators, microvesicles, tissue factor expression and endothelial activation, attention should be paid to the molecular aspects of platelet activation in renal replacement therapy with regional citrate coagulation.   Conclusion. The widespread use of extracorporeal detoxification methods is an independent risk factor not only for bleeding events, but may potentially contribute to thrombosis and thromboembolic complications, which requires a further detailed study of molecular mechanisms of hemostasis regulation by tumor and clinical evaluation of various anticoagulation methods.https://www.surgonco.ru/jour/article/view/814ovarian malignancieshemostatic systemp-selectin expressionrenal replacement therapyhemodialysisrenal failurerisk factors
spellingShingle A. S. Safonov
M. V. Zabelin
A. A. Izmailov
Z. A. Valiullina
A. R. Mukhametkulova
A. V. Vasilchenko
K. N. Zolotukhin
Extracorporeal Detoxification Methods and Hemostasis System for Ovarian Cancer Patients. Clinical Case
Креативная хирургия и онкология
ovarian malignancies
hemostatic system
p-selectin expression
renal replacement therapy
hemodialysis
renal failure
risk factors
title Extracorporeal Detoxification Methods and Hemostasis System for Ovarian Cancer Patients. Clinical Case
title_full Extracorporeal Detoxification Methods and Hemostasis System for Ovarian Cancer Patients. Clinical Case
title_fullStr Extracorporeal Detoxification Methods and Hemostasis System for Ovarian Cancer Patients. Clinical Case
title_full_unstemmed Extracorporeal Detoxification Methods and Hemostasis System for Ovarian Cancer Patients. Clinical Case
title_short Extracorporeal Detoxification Methods and Hemostasis System for Ovarian Cancer Patients. Clinical Case
title_sort extracorporeal detoxification methods and hemostasis system for ovarian cancer patients clinical case
topic ovarian malignancies
hemostatic system
p-selectin expression
renal replacement therapy
hemodialysis
renal failure
risk factors
url https://www.surgonco.ru/jour/article/view/814
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AT mvzabelin extracorporealdetoxificationmethodsandhemostasissystemforovariancancerpatientsclinicalcase
AT aaizmailov extracorporealdetoxificationmethodsandhemostasissystemforovariancancerpatientsclinicalcase
AT zavaliullina extracorporealdetoxificationmethodsandhemostasissystemforovariancancerpatientsclinicalcase
AT armukhametkulova extracorporealdetoxificationmethodsandhemostasissystemforovariancancerpatientsclinicalcase
AT avvasilchenko extracorporealdetoxificationmethodsandhemostasissystemforovariancancerpatientsclinicalcase
AT knzolotukhin extracorporealdetoxificationmethodsandhemostasissystemforovariancancerpatientsclinicalcase