[Antithrombin III in chronic renal insufficiency].

Area of Science:

• Nephrology
• Hematology
• Biochemistry

Context:

• Chronic renal failure (CRF) and chronic hemodialysis (CHD) patients exhibit complex hemostatic alterations.
• Bleeding and thrombosis are significant complications in patients with CRF and uremia.
• Antithrombin III (AT III) plays a key role in regulating coagulation.

Purpose:

• To investigate the biologic activity of Antithrombin III in patients with CRF and CHD.
• To assess the impact of heparin on AT III biologic activity in hemodialysis patients.
• To determine if antigenic levels of AT III correlate with its functional activity.

Summary:

• Biologic activity of AT III was significantly increased in CRF patients, potentially explaining bleeding tendencies.
• In hemodialysis patients, heparin administration significantly decreased AT III biologic activity to levels associated with thrombosis.
• Antigenic levels of AT III remained unchanged post-heparin, highlighting a dissociation between quantity and function.

Impact:

• Measuring biologic activity of AT III is essential, as quantity alone is an unreliable indicator of its functional validity.
• Altered AT III biologic activity, particularly post-heparin, contributes to the high thrombosis risk in hemodialysis patients.
• These findings underscore the need for targeted monitoring of AT III function in renal failure patients to optimize management and prevent thrombotic events.