HEMODIALYSIS AND BLOOD-COAGULATION - THE EFFECT OF HEMODIALYSIS ON COAGULATION FACTOR-XIII AND THROMBIN-ANTITHROMBIN-III COMPLEX

被引:11
作者
KOLB, G [1 ]
FISCHER, W [1 ]
SEITZ, R [1 ]
MULLER, T [1 ]
EGBRING, R [1 ]
LANGE, H [1 ]
HAVEMANN, K [1 ]
机构
[1] UNIV HOSP MARBURG,DIV NEPHROL,MARBURG,GERMANY
来源
NEPHRON | 1991年 / 58卷 / 01期
关键词
HEMODIALYSIS; COAGULATION FACTOR-XIII; SUBUNIT-A AND SUBUNIT-S; THROMBIN-ANTITHROMBIN-III COMPLEX; POLYMORPHONUCLEAR ELASTASE; ACUTE RENAL FAILURE; CHRONIC RENAL FAILURE; CUPROPHANE; HEMOPHANE;
D O I
10.1159/000186388
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Blood membrane interaction during hemodialysis (HD) regularly leads to stimulation of leukocyte function and related release of granular enzymes. The present study aimed to investigate the possible influence of an HD-induced release of granulocyte elastase on blood coagulation. Therefore a highly sensitive substrate of polymorphonuclear elastase, the plasma coagulation factor XIII and its subunits A and S were determined in the course of HD. Consumption of both subunit A and S have been previously shown to be due to proteolysis by elastase, whereas a decrease in subunit A will be typical for thrombin activation. Furthermore, the thrombin-antithrombin III complex (TAT) acting as a predisposition parameter for thrombotic events was measured during HD treatment. Apart from a virtual fall in factor XIII total activity simulated by heparin, no significant HD-induced consumption of factor XIII could be observed. There was also no indication of an elastase- or thrombin-related change in subunit concentrations. Predialysis values of the TAT complex were generally elevated in HD patients, but only patients with acute renal failure showed a constant increase of TAT during HD. These findings suggest that HD patients are exposed to a latent activation of coagulation resulting in an elevated thrombogenetic risk mainly due to the underlying disease. An additional coagulatory stimulation by the HD procedure seems to be restricted to cases of acute renal failure.
引用
收藏
页码:106 / 108
页数:3
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