ENHANCED COAGULATION-FIBRINOLYSIS IN PATIENTS ON REGULAR HEMODIALYSIS-TREATMENT

Thirty-three patients with chronic uremia on regular hemodialysis treatment (RDT) have been studied to determine whether coagulation and fibrinolysis are enhanced or not. We examined predialysis values of coagulation and fibrinolysis parameters including alpha-2-plasmin inhibitor-plasmin complex (alpha-2-PIC), a good index of in vivo plasmin production, and cross-linked fibrin degradation products (XL-FDP), an index of fibrinolysis secondary to coagulation. Fibrinogen was significantly higher (p < 0.001) in RDT patients than in normal controls. ATIII activity was significantly lower in RDT patients than in normal controls (p < 0.001). Plasminogen activity and alpha-2-plasmin inhibitor (alpha-2-PI) activity were significantly lower (p < 0.001) in RDT patients than in normal controls. alpha-2-PIC and XL-FDP were both significantly higher (p < 0.001) in RDT patients than in normal controls. XL-FDP was inversely correlated with alpha-2-PI (r = -0.486, p < 0.01) and positively correlated with alpha-2-PIC (r = 0.646, p < 0.001). These results suggest that coagulation and fibrinolysis are enhanced in RDT patients and that the enhanced fibrinolysis is mainly due to fibrinolysis secondary to coagulation.