Further Investigations of the Defective Protein C in Hemodialysis, Hemofiltration and Continuous Ambulatory Peritoneal Dialysis

Sørensen, Per; Nielsen, Arne Høj; Knudsen, Flemming; Dyerberg, Jørn

doi:10.1159/000169596

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…Variable levels o f coagulation factors have been reported in C A P D [11], Protein C level activity has been shown to be normal or reduced in haemodialysis and C A P D patients. One report demonstrated a rise in activity after haemodialysis [31]. Changes such as these in natural anticoagulant factor levels induced by dialysis may account for the differences in coagulation observed in the present study between the C A P D and haemodialysis patients.…”

Section: Discussionsupporting

confidence: 51%

“…There have been few reports ad dressing the possibility of platelet activation in C A P D patients [30]. Increased platelet aggregation to adrenaline has been described in both C A P D and haemodialysis pa tients [13,31], and Sabo et al [13] reported a lower threshold for secretion o f malondialdehyde from platelets in C A P D patients. They concluded that this marker of enhanced platelet activation was secondary to the hypertriglyceridaemia which was present in their group o f patients.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Haemostatic Activity in Haemodialysis and Peritoneal Dialysis Patients with a Novel Technique, Haemostatometry

Roger

Piper²,

Tucker³

et al. 1992

Nephron

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Bleeding due to impaired primary haemostasis is common in uraemia. However, thromboembolic episodes are also a clinical problem in dialysis patients. Platelet reactivity to shear stress (haemostasis, H1 and H2), exposure to collagen fibre (thrombus growth) and coagulation of flowing blood (clotting time, CT1 and CT2) were measured in non-anticoagulated blood samples taken immediately before and 18-24 h after haemodialysis (n = 26) and from patients maintained on continuous ambulatory peritoneal dialysis (CAPD, n = 30). H1 (p < 0.001), H2 (p < 0.01), percent thrombus growth rate (p < 0.03), CT1 (p < 0.01 and CT2 (p < 0.05) were restored towards normal after haemodialysis. Results obtained in the CAPD patients demonstrated that the mean values for formation of the haemostatic plug lay between the pre- and posthaemodialysis values; however, CT1 (p < 0.01) and CT2 (p < 0.05) were prolonged in CAPD compared with values after haemodialysis. These data, which indicate platelet function from non-anticoagulated blood and coagulation under flow conditions, (1) confirm that there is impaired haemostasis in uraemia; (2) demonstrate an improvement in haemostasis after haemodialysis; (3) show that peritoneal dialysis results in a haemostatic profile which falls between the pre-and posthaemodialysis pattern, and (4) show that neither dialysis modality returns haemostasis to normal.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Comparison of Haemostatic Activity in Haemodialysis and Peritoneal Dialysis Patients with a Novel Technique, Haemostatometry

Roger

Piper²,

Tucker³

et al. 1992

Nephron

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“…Protein C activity has been found to be reduced in small series of patients with acute renal failure, chronic renal failure, and renal allograft rejection, as well as in maintenance HD patients (61–64). Reports of the effect of dialysis on protein C activity are conflicting.…”

Section: Alterations In Clotting Factors and Markers Of Coagulationmentioning

confidence: 99%

Thrombosis in End‐Stage Renal Disease

Casserly

Dember

2003

Seminars in Dialysis

146

122

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Although renal failure has classically been associated with a bleeding tendency, thrombotic events are common among patients with end-stage renal disease (ESRD). A variety of thrombosis-favoring hematologic alterations have been demonstrated in these patients. In addition, "nontraditional" risk factors for thrombosis, such as hyperhomocysteinemia, endothelial dysfunction, inflammation, and malnutrition, are present in a significant proportion of chronic dialysis patients. Hemodialysis (HD) vascular access thrombosis, ischemic heart disease, and renal allograft thrombosis are well-recognized complications in these patients. Deep venous thrombosis and pulmonary embolism are viewed as rare in chronic dialysis patients, but recent studies suggest that this perception should be reconsidered. Several ESRD treatment factors such as recombinant erythropoietin (EPO) administration, dialyzer bioincompatibility, and calcineurin inhibitor administration may have prothrombotic effects. In this article we review the pathogenesis and clinical manifestations of thrombosis in ESRD and evaluate the evidence that chronic renal failure or its management predisposes to thrombotic events.

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“…The low coagulant protein C activity is apparently related to impaired graft function, albeit in an unknown way. This may be due to incomplete dicarboxylation of protein C in uraemia [11] or to the presence of a hitherto unknown protein C inhibitor [12]. We are at present unable to explain this finding.…”

Section: Discussionmentioning

confidence: 91%

Protein C in renal allotransplantation during the perioperative period

Sørensen

Nielsen

Knudsen

et al. 1989

Journal of Internal Medicine

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Protein C activity, both coagulant and amidolytic, as well as antigen level were studied during the perioperative period in 40 renal transplants recipients and 21 healthy controls. At transplantations the protein C coagulant activity was significantly lower in the patients than in the normal controls, and further decreased in the patients during the first week after transplantation, whereas the amidolytic activity of protein C was normal and the protein C antigen level was elevated. In the patients with established kidney function, protein C coagulant activity was higher than in patients with impaired graft function. Furthermore, it seems that the protein C coagulant activity was closely related to changes in graft function in the 11 patients with graft rejection episodes. The low protein C coagulant activity following renal transplantation could be a contributing factor to thromboembolic complications.

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Further Investigations of the Defective Protein C in Hemodialysis, Hemofiltration and Continuous Ambulatory Peritoneal Dialysis

Cited by 7 publications

References 11 publications

Comparison of Haemostatic Activity in Haemodialysis and Peritoneal Dialysis Patients with a Novel Technique, Haemostatometry

Comparison of Haemostatic Activity in Haemodialysis and Peritoneal Dialysis Patients with a Novel Technique, Haemostatometry

Thrombosis in End‐Stage Renal Disease

Protein C in renal allotransplantation during the perioperative period

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