Association between tissue factor, its pathway inhibitor and oxidative stress in peritoneal dialysis patients

The abnormalities of tissue factor and its inhibitor system, increased oxidative stress and the presence of diabetes may be involved in the mechanism of thrombotic complication in peritoneal dialysis patients. We compared the plasma levels of tissue factor, its inhibitor and markers of oxidative stress (malondialdehyde and Cu/Zn superoxide dismutase) in 16 diabetic peritoneal dialysis patients, 40 nondiabetic peritoneal dialysis patients, and 20 healthy control individuals. We tried to establish whether there is an association between tissue factor, its inhibitor and oxidative stress in these patients. Compared with the control individuals, the patients both with and without diabetes showed a significant increase in plasma concentrations of Cu/Zn superoxide dismutase (P < 0.01 and P < 0.001, respectively), malondialdehyde (both P < 0.05), tissue factor (both P < 0.001) and tissue factor pathway inhibitor (P < 0.01 and P < 0.001, respectively). The differences in oxidative status and coagulation parameters between patients with and without diabetes were not statistically significant. In all peritoneal dialysis patients, both tissue factor and its inhibitor were positively related to Cu/Zn superoxide dismutase (r = 0.310, P < 0.05 and r = 0.460, P < 0.001, respectively) and malondialdehyde levels (r = 0.337, P < 0.05 and r = 0.361, P < 0.01, respectively). Our data suggest a relationship between increased oxidative stress and elevated tissue factor and its inhibitor levels in peritoneal dialysis patients, particularly those with diabetes.