STATE OF ENDOTHELIAL FUNCTION AND HEMOSTASIS SYSTEM IN PATIENTS ON HEMODIALYSIS
https://doi.org/10.24884/1561-6274-2010-14-4-48-52
Abstract
THE AIM of the study – to assess the state of endothelial function and indices of aggregation of platelet function, coagulation hemostasis and anticoagulant activity in patients on program hemodialysis treatment. PATIENTS AND METHODS. Examined 89 patients on hemodialysis. All patients measured the concentration of stable metabolites in blood serum (nitrites, nitrates, total metabolites of nitric oxide), indicators of lipid profile, homocysteine levels. The aggregation of platelets, coagulation hemostasis, anticoagulation activity, activation of blood coagulation tests were studied. RESULTS. Mean concentrations of homocysteine, von Willebrand factor in hemodialysis patients were higher than in the comparison group. The concentration of stable metabolites of nitric oxide in the studied group was significantly lower than in healthy individuals. Significant improvement of atherogenic lipoproteins in patients on hemodialysis was discovered. The changes in hemostasis indicate the presence of signs of activation of intravascular coagulation. According to the correlation analysis, multivariate regression analysis indicated the existence of a relationship between homocysteine concentration, indicators of atherogenic lipid profile, von Willebrand factor and indicators hemostaziogrammy. CONCLUSION. In patients receiving hemodialysis treatment there is activation of intravascular coagulation of blood does not reveal the routine coagulation studies. In patients on hemodialysis was revealed endothelial dysfunction. According to the correlation analysis, multivariate regression analysis there is an interrelation between indices of endothelial function and hemostasiogramma.
About the Authors
U. V. KharlamovaRussian Federation
O. E. Il’icheva
Russian Federation
References
1. Ильин АП, Богоявленский ВФ. Тромбофилия при гемодиализе у больных хронической почечной недостаточностью и ее фраксинопрофилактика и терапия. Казань, 2001; 3-32
2. Cella G, Vertolli U, Naso A. et al. Tissue factor pathway inhibitor (TFPI) activity in uremic patients during hemodialysis. Thromb Res 1996; 81: 671-677
3. Манухина ЕБ, Малышев ИЮ. Роль оксида азота в седечно-сосудистой патологии: взгляд патофизиолога. Росскардиологич журн 2000; (5): 55-63
4. Bostom A, Brosnan JT, Hall B. Net uptake of plasma homocysteine by the rat kidney in vivo. Atherosclrrosis 1995; 116: 59-62
5. Suliman ME, Divino Filho JC, Barany P. et al. Effects of high-dose folic acid and pyridoxine on plasma and erythrocite sulfur amino acids in hemodialisis patients. J Am Soc Nephrol 1999; 10: 1287-1296
6. Смирнов АВ, Есаян АМ, Каюков ИГ. и др. Современные подходы к замедлению прогрессирования хронической болезни почек. Нефрология 2004; (3): 89-99
7. Hoenicb NA. Platelet and leucocytes behaviour during haemodialysis. Contrib Nephrol 1999; 125; 120-132
8. Lang D, Kredan MB, Lang D, Moat SJ. et al. Homocysteine–induced inhibition of endothelium–dependent relaxation in rabbit aorta: Role for superoxide anions. Arterioscler Thromb Vasc Biol 2000; 5: 257-261
9. Thambyrajah J, Landray MJ, McGlynn FJ, Jones HJ. еt al. Does folic acid decrease plasma homocysteine and improve endothelial function in patients with predialysis renal failure? Circulation 2000; 102: 871-875
10. Van Guldener C, Lambert J, Janssen MJ, Donker AJ, Stehouwer CD. Endothelium-dependent vasodilatation and distensibility of large arteries in chronic haemodialysis patients. Nephrol Dial Transplant 1997; 12: 14-18
11. Kanani P, Sinkey C, Browning R. et al. Role of oxidant stress in endothelial dysfunction produced by experimental hyperhomocysteinemia in humans. Circulation 1999; 100: 1161-1168
12. Tawakol A, Forgione M, Stuehlinger M. et al. Homocysteine impairs coronary microvascular dilator function in humans. JACC 2002; 40 (6): 1051–1058
13. Loscalo J. The oxidant stress of hyperhomocyst(e)inemia. J Clin Invest 1996; 98 (1): 5-7
14. Tawakol A, Omland T, Gerhard M. et al. Hyperhomocyst(e)inemia is associated with impaired endothelium-dependant vasodilatation in humans. Curculation 1997; 95: 1119-1121
15. Sagripanti A, Cupisti A, Baicchi U. et al. Plasma parameters of the protrombotic state in chronic uremia. Nephron 1993; 63: 273-278
16. Mayer E, Jacobsen D, Robinson K. Homocysteine and coronary atherosclerosis. J Am Coll Cardiol 1996; 27: 517-527
17. Stein J, Mc Bride P. Hyperhomocysteinemia and atherosclerotic vascular disease. Arch Intern Med 1998; 158: 1301-1306
18. Bardic R, Rugerri ZM, Savion N et al. Platelet aggregation on extracellular matrix: effect of a recombination GPIb-binding fragment of von Willebrand factor. Thromb Haemos 1993; 70: 522-526
19. Blann AD. Von Willebrand factor and the endothelium in vascular disease. Brit J Biomed Sci 1993; 50: 124-134
20. Ruggery ZM, Ware J, Ginsberg D. Von Willebrand factor. Thrombosis and Haemorrhage 1994; 67: 305-329
Review
For citations:
Kharlamova U.V., Il’icheva O.E. STATE OF ENDOTHELIAL FUNCTION AND HEMOSTASIS SYSTEM IN PATIENTS ON HEMODIALYSIS. Nephrology (Saint-Petersburg). 2010;14(4):48-52. (In Russ.) https://doi.org/10.24884/1561-6274-2010-14-4-48-52