ADAMTS13 and Von Willebrand factor in patients undergoing hemodialysis

Abstract

Hemodialysis (HD) is associated with increasing thrombotic trend. Vascular access thrombosis (VAT) increases morbidity in HD patients. The aim of this study was to evaluate ADAMTS13 and VWF plasma levels from patients undergoing HD as putative biomarkers of the hypercoagulability state, as well the association between these markers and VAT occurrence. This study included 195 patients on HD for more than 6 months. HD patients were allocated into two groups according to the occurrence or not of previous episode of VAT; HD with VAT (N = 46) and HD without VAT (N = 149). ADAMTS13 and VWF were performed by ELISA. There was no significant difference between HD patients with and without VAT for ADAMTS13 and VWF levels. However, VWF levels were higher (P < 0.001) and ADAMTS13 were lower (P < 0.001) in HD patients, comparing to the control group composed by healthy subjects without kidney disease, age and sex-matched (N = 80). Taken together our data suggest a potential role of the kidneys function compromised on ADAMTS13 synthesis or metabolism, regardless other known sources of ADAMTS13. The imbalance between ADAMTS13 and VWF levels does not explain the development of VAT in HD patients by itself, although it should contribute for the hypercoagulability state. Therefore, additional studies to identify other risk factors are warranted and essential for better management of HD patients.

Quantitative and qualitative changes of von Willebrand factor and their impact on mortality in patients with end-stage kidney disease

“…In contrast, others have reported significantly lower levels of ADAMTS-13 in dialysis patients and patients with CKD using an antigen-based assay [8]. In contrast, others have reported significantly lower levels of ADAMTS-13 in dialysis patients and patients with CKD using an antigen-based assay [8].…”

“…It is well documented that vWF antigen levels are markedly elevated in patients with chronic kidney disease (CKD) [3][4][5][6][7][8][9][10][11][12]. This may be due to hyperstimulation of vWF endothelial secretion pathways as most circulating vWF is derived from the endothelium.…”

Correlation of von Willebrand factor gene polymorphism and coronary heart disease

“…The plasma vWF levels of the normal population with blood type O were significantly lower than those of the other blood types. A previous study has shown that the ADAMTS13 metalloproteinase is able to inactivate plasma vWF by hydrolysis (14), while glycophorin glycosyltransferase is able to inhibit the hydrolysis of the metalloproteinase for vWF. There is a congenital lack of the relevant transferase in blood type O.…”

Hemostatic Parameters according to Renal Function and Time after Transplantation in Brazilian Renal Transplanted Patients

“…The hemostasis/fibrinolysis evaluation in renal transplanted patients in this study included the determination of four biomarkers: D-DI, TM, VWF, and ADAMTS13 levels. Our research group have previously studied these hemostatic markers in the same group of patients before renal transplantation and showed that the imbalance between ADAMTS13 and VWF levels may contribute to the hypercoagulability state [ 17 , 18 ]. In the present, our data showed higher D-DI plasma levels in subgroup C3 (creatinine > 2.0 mg/dL) as compared to C1 (creatinine < 1.4 mg/dL), which suggest that impaired glomerular filtration influences D-DI clearance and may favor a thrombotic or hypofibrinolytic state.…”