Significant histomorphometric results of cellular parameters in femur (upper panel) and vertebra (lower panel) analysis of rats.

<p>The main alteration of cellular parameters in warfarin treated rats was the increased osteoclast activity (ES/BS), although in femur a decreased osteoblast activity (OS/BS) was also detected. ES/BS: Erosion Surface / Bone Surface; OS/BS: Osteoid Surface / Bone Surface. *p< 0.01 vs control; #p<0.001 vs dabigatran; ##p< 0.005 vs dabigatran.</p

Dabigatran preserves vertebral volume and structure.

<p>According to what observed in the femur, analysis of vertebrae showed increased bone volume, trabecular thickness and number, with lesser trabecular separation in rats treated with dabigatran with respect to warfarin treated study animals. Bone of a representative normal control rat is also shown. No significant differences in microarchitecture were observed between study groups. Warfarin treated rats showed thinner trabeculae with increased separation in the marrow space, highlighting a potentially increased fragility, despite similar microarchitecture. (Magnification 100X).</p

Histomorphometric parameters in femur and vertebra (S2 Dataset and S3 Dataset).

<p>*<b>p< 0.05 vs control and dabigatran groups;</b></p><p>** <b>p<0.001 vs control and dabigatran groups.</b></p><p>Histomorphometric parameters in femur and vertebra (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0133847#pone.0133847.s002" target="_blank">S2 Dataset</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0133847#pone.0133847.s003" target="_blank">S3 Dataset</a>).</p

Regions of Interest (ROI) for histomorphometric analyses for femur (1A) and vertebra (1B).

<p>For femur analysis, we analyzed the trabecular and cortical bone (in green) of the secondary spongiosa area between 2 and 4 mm distal to the growth plate-metaphyseal junction in the upper part of the diaphysis. Concerning the vertebrae, we selected lumbar vertebrae and considered the middle area in frontal sections to evaluate trabecular and cortical bone parameters.</p

Significant histomorphometric results of structural and dynamic parameters in vertebrae of rats.

<p>Similar to the findings in femur, in warfarin treated rats we observed lower bone volume and trabecular thickness with increased trabecular separation compared to dabigatran treated and control rats. In addition, treatment with warfarin was associated with a significant increase of turnover parameters, i.e. BFR/BS and activation frequency. Microarchitecture, cortical thickness and porosity were similar among groups. Only rats treated with warfarin showed an alteration of bone volume and structure, suggesting increased bone fragility compared to dabigatran and control rats pattern. *p<0.05,** p< 0.01, ***p<0.001 vs control; #p<0.05, ## p< 0.01, ###p<0.001 vs dabigatran.</p

Significant histomorphometric results of structural and dynamic parameters in femur rats.

<p>In warfarin treated rats we observed lower bone volume and trabecular thickness with increased trabecular separation compared to dabigatran treated and control rats. In addition, treatment with warfarin was associated with a significant increase of turnover parameters (i.e. BFR/BS) and, in particular, activation frequency was higher in warfarin treated rats versus dabigatran treated or control rats. Microarchitecture, cortical thickness and porosity were similar among groups. Only rats treated with warfarin showed an alteration of bone volume and structure, suggesting increased bone fragility compared to dabigatran and control rats pattern. For the meaning of abbreviations see <b><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0133847#pone.0133847.t002" target="_blank">Table 2</a></b>. *p<0.05, **p< 0.01, ***p<0.001 vs control; # p<0.05, ##p< 0.01, ### p<0.001 vs dabigatran.</p

Anticoagulation parameters (S1 Dataset).

<p>Data are expressed as mean ± SEM</p><p>n.a. = not available.</p><p>* indicates p<0.001 vs. dabigatran or control</p><p># indicates p<0.001 vs. controls</p><p>Anticoagulation parameters (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0133847#pone.0133847.s001" target="_blank">S1 Dataset</a>).</p

Participants’ characteristics.^a)

<p>Participants’ characteristics.<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0128228#t001fn001" target="_blank">^a)</a></p

Comparing priority ratings between kidney patients and clinicians for topics to which <i>clinicians</i> assigned high priority, but that were absent in patients’ top 10.

<p>Abbreviations: N, number of respondents who rated the importance of a topic; SD, standard deviation</p

Flow chart of process of identifying and prioritizing treatment decisions (i.e., topics) around permanent vascular access

<p>Flow chart of process of identifying and prioritizing treatment decisions (i.e., topics) around permanent vascular access</p