Plasma von Willebrand factor and thrombomodulin as markers of vascular disorders in patients undergoing regular hemodialysis therapy

Tomura, Shigeo; Nakamura, Yoshihiro; Deguchi, Fusae; Chida, Yoshiko; Ohno, Yasuo; Kodama, Shuji; Hayashi, Tatsuya; Suzuki, Kouji; Marumo, Fumiaki

doi:10.1016/0049-3848(90)90212-u

Cited by 60 publications

(51 citation statements)

References 16 publications

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“…Increased levels von Willebrand factor have previously been observed in patients with kidney disease and in those on dialysis [8,27]. We did not find any correlation between renal function and von Willebrand factor in patients with renal insufficiency which is in accordance with previous observations [27].…”

Section: Discussionsupporting

confidence: 82%

“…The physiological function has not fully been understood but it is thought to indicate endothelial cell damage and the risk of atherosclerotic disease [5][6][7]. Increased levels of von Willebrand factor are found in numerous clinical settings where damaged or dysfunctional endothelial cells are present, such as in inflammatory and atherosclerotic vascular disease [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Recent data indicate that patients with vascular disease who have the highest concentration of von Willebrand factor have a more severe disease and that soluble VCAM-1 correlates with angiographically defined severity of peripheral atherosclerosis [14][15][16]. The plasma concentrations of thrombomodulin and von Willebrand factor are increased in patients with end-stage renal disease maintained on dialysis [8,[17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Correlation between Soluble Markers of Endothelial Dysfunction in Patients with Renal Failure

Jacobson¹,

Egberg²,

Hylander³

et al. 2002

Am J Nephrol

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Aim: Damage to the endothelium is an important component of atherosclerosis. It has been suggested to be quantified by measuring plasma markers, such as von Willebrand factor and thrombomodulin and soluble adhesion molecules. We hypothesized there may exist a correlation between the plasma levels of von Willebrand factor and thrombomodulin as markers of endothelial cell dysfunction and the serum concentrations of soluble adhesion molecules and monocyte chemoattractant protein-1 (MCP-1) in patients with renal insufficiency, and in patients on peritoneal dialysis or hemodialysis since these three groups of kidney patients are highly prone to develop cardiovascular diseases. Results: The concentrations of von Willebrand factor and thrombomodulin in plasma were significantly higher in patients with kidney diseases as compared to healthy subjects (p = 0.017 and p < 0.001, respectively). The patients also had significantly higher concentrations of soluble vascular cell adhesion molecule-1 (sVCAM-1) and MCP-1 compared to healthy controls (p < 0.001 for both comparisons). There were strong correlations between the concentration of soluble intercellular adhesion molecule-1 (sICAM-1) and von Willebrand factor in patients with kidney failure (r = 0.63, p < 0.001) and between the concentration of thrombomodulin and sVCAM-1 (r = 0.61, p < 0.001). Furthermore, a negative correlation was observed between the concentration of thrombomodulin and the cell surface expression of CD11b on monocytes and granulocytes in the peripheral circulation (p < 0.01 in both cases). Conclusion: The strong correlation between markers of endothelial dysfunction and soluble adhesion molecules in patients with renal insufficiency and on dialysis strengthen the view that an ongoing stress on endothelial cells is present in this group of patients. This may play a pathophysiological role in the development of cardiovascular disease.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Correlation between Soluble Markers of Endothelial Dysfunction in Patients with Renal Failure

Jacobson¹,

Egberg²,

Hylander³

et al. 2002

Am J Nephrol

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“…In this respect, we had to exclude dialysis patients because of their complicated hemostatic system [13][14][15][16][17][18] and we also had to adopt hemostastatic markers that are not affected by renal elimination. Both TAT and D-dimer are known to have high molecular weights, so excretion of these markers from the kidney is very limited.…”

Section: Discussionmentioning

confidence: 99%

Impact of Decreased Renal Function on Coagulation and Fibrinolysis in Patients With Non-Valvular Atrial Fibrillation

Tanaka

Sonoda

Kashima

et al. 2009

Circ J

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Background:The prothrombotic state in non-valvular atrial fibrillation (NVAF) increases the risk of thromboembolic events. It is also well known that a prothrombotic state exists in renal failure. Hemostatic disorders play a role in thromboembolic mortality in both NVAF and renal failure. However, little is known about the influence of renal function on hemostasis in patients with NVAF. Methods and Results: A total of 190 consecutive outpatients with NVAF who were not receiving anticoagulant therapy were enrolled in the present study. Patients were stratified in groups based on estimated glomerular filtration rate (eGFR). Plasma concentrations of thrombin-antithrombin complex (TAT) and D-dimer were measured and the influence of renal function on coagulation and fibrinolysis was assessed. A relatively weak and inverse relationship of eGFR to TAT and D-dimer was observed (r=0.28, P=0.0001; r=0.30, P<0.0001). Both mean TAT and D-dimer concentrations in groups gradually and significantly increased as eGFR decreased (P<0.0001). On multivariate regression analysis, decreased eGFR concentration was a significant predictor for elevation of TAT (P<0.05) and D-dimer (P<0.01) in patients with NVAF. Conclusions:The enhanced coagulation activation appeared to be related to a reduction in residual renal function in patients with NVAF. This suggests that decreased renal function might be a candidate predictor of thromboembolic events in patients with NVAF. (Circ J 2009; 73: 846 -850)

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“…Bunlardan biri olan vWF düzeyleri hemodiyaliz hastalarında sürekli yüksek bulunmuştur. Bu maddenin plazma konsantrasyonundaki artış endotelyal hasarla ilgili olup, kalp-damar hastalıklarının ilerlemesi ve gelişmesinin habercisi olduğu düşünülmektedir (16,17).…”

Section: Introductionunclassified

The Effect of Different Antihypertensive Treatment Methods on Endothelial Functions in Patients With Chronic Renal Failure on Hemodialysis

Günal¹,

Üstündağ²,

Günal³

2010

Turk Neph Dial Transpl

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ÖZKronik böbrek yetmezliğinde hipertansiyon, hipervolemi ve üremik toksinler endotel disfonksiyonuna neden olarak hızlanmış ateroskleroza yol açmaktadır. Renal replasman tedavisi almakta olan kronik böbrek yetmezlikli hastaların büyük çoğunluğu hipertansif ve hipervolemiktir. Bu iki risk faktörü en önemli mortalite nedeni olarak kabul edilmektedir. Antihipertansif ilaç alarak normotansif hale gelen hastalarda beş yıllık yaşam beklentisi %40-50'lerde iken, sıkı volüm kontrolüyle normotansiyon sağlananlarda ise on yıllık yaşam beklentisi %70'lere çıkmaktadır. GEREÇ ve YÖNTEm:Çalışma grupları, kontrol grubu (n=30), hemodiyalize giren ve sıkı volüm kontrolü uygulanarak normotansif olan hasta grubu (HD vk ) (n=30) ve hemodiyalize giren ve antihipertansif ilaç kullanarak normotansif olan hasta grubu (HD ilaç ) (n=30) şeklinde oluşturuldu. Tüm gruplarda, von Willebrand factor (VWF), D-Dimer, nitrik oksit (NO), homosistein ve rutin biyokimya parametrelerine bakıldı.BULGULAR: HD ilaç grubunun iki diyaliz arası kilo alımı, HD vk uygulanan gruba göre anlamlı olarak yüksek olmasına rağmen (p<0,001), HD ilaç 'ın tansiyonu kabul edilebilir değerler içindeydi. Ancak, vWf düzeyi ve D-dimer düzeyleri HD vk uygulanan hemodiyaliz hastalarında, HD ilaç uygulanan hastalara göre düşük düzeydeydi.soNUÇ: Sonuç olarak, diyaliz hastalarında yüksek kan basıncını antihipertansif ilaçlarla tedavi etmeye çalışmak, bozuk olan endotel fonksiyonlarını düzeltmemektedir. Sıkı volüm kontrolüyle, hastaların hipertansiyonları daha iyi kontrol altına alınabilirken, endotel fonksiyonları da oldukça iyi korunabilmektedir. ANAHTAR sÖZCüKLER: Kronik böbrek yetmezliği, Endotel, Volüm kontrolü, Antihipertansifler ABsTRACTHypervolemia and uremic toxins result in accelerated atherosclerosis in chronic renal failure by causing endothelial dysfunction hypertension. The vast majority of patients undergoing renal replacement therapy are hypertensive and hypervolemic. It is accepted that these two risk factors are the most important causes of mortality. While five-year survival in hemodialysis patients using antihypertensive drugs is 40-50%, ten-year survival in hemodialysis patients applied strict volume control is 70%. mATERiAL and mETHoD: The study was composed of three groups as follows: control group (n=30), hemodialysis patients (normotensive with hypotensive drugs HD drug , n=30), hemodialysis patients (normotensive with strict volume control HD vc , n=30). von Willebrand factor (vWF), D-dimer, nitric oxide (NO), homocysteine and routine biochemical parameters were studied in all groups.REsULTs: Although the interdialytic weight gain of the hemodialysis patients using antihypertensive drugs was higher than hemodialysis patients applied strict volume control (p<0.001), the blood pressure of the drug users was within the acceptable levels. However, the levels of vWF, and, D-dimer in patients applied volume control were lower than that of HD drug . CoNCLUsioN:In conclusion, although antihypertensive drugs can decrease elevated blood pressure to a limited exte...

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Plasma von Willebrand factor and thrombomodulin as markers of vascular disorders in patients undergoing regular hemodialysis therapy

Cited by 60 publications

References 16 publications

Correlation between Soluble Markers of Endothelial Dysfunction in Patients with Renal Failure

Correlation between Soluble Markers of Endothelial Dysfunction in Patients with Renal Failure

Impact of Decreased Renal Function on Coagulation and Fibrinolysis in Patients With Non-Valvular Atrial Fibrillation

The Effect of Different Antihypertensive Treatment Methods on Endothelial Functions in Patients With Chronic Renal Failure on Hemodialysis

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