Patients on peritoneal dialysis but not on hemodialysis have elevated concentration and activity of thrombin-activatable fibrinolysis inhibitor

Cardiovascular disease (CVD) is a leading cause of death in patients on dialysis. Increased concentration of fibrinogen, dyslipidemia and impaired fibrinolysis are regarded as important risk factors for CVD. Thrombin-activatable fibrinolysis inhibitor (TAFI) is a recently discovered inhibitor of the fibrinolytic system. The aim of this study was to investigate whether peritoneal dialysis (PD) and hemodialysis (HD) patients differ with regard to TAR concentration and/or its activity. We also measured albumin, cholesterol, triglycerides and fibrinogen. The study was performed on 35 chronically dialyzed patients (14 on PD and 21 on HD) and 18 healthy volunteers. TAFI antigen and its activity were measured with commercially available kits. Albumin, cholesterol, triglycerides and fibrinogen were measured using standard laboratory methods. Only PD patients had significantly elevated level of TAR antigen and its activity compared to control subjects. Differences in TAFI concentration and its activity between PD and HD were at the level of statistical significance (P = .09 and P = .07, respectively). PD patients had significantly higher concentration of cholesterol and triglycerides than HD group. Fibrinogen was elevated significantly in PD patients compared to HD and controls. There was no difference in albumin concentration between PD and HD. Significant positive correlations were found between fibrinogen or triglycerides and TAFI activity only in PD patients. We conclude that the above phenomenon may predispose PD patients to suppression of fibrinolysis. (C) 2001 Elsevier Science Ltd. All rights reserved.