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Haemostatic activation and proteinuria as factors in the progression of chronic renal failure

M P Gordge1, B R Leaker, P B Rylance

  • 1Department of Renal Medicine, University College and Middlesex School of Medicine, University College London, UK.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 1, 1991
PubMed

Insights

Patients with chronic renal failure (CRF) and diabetic nephropathy show heightened haemostatic activation. Proteinuria, serum thromboxane B2 (TxB2), and von Willebrand factor antigen (vWFAg) are key factors in disease progression.

Area of Science:

  • Nephrology
  • Hematology
  • Clinical Biochemistry

Background:

  • Chronic renal failure (CRF) and diabetic nephropathy are associated with complex pathophysiological changes.
  • Haemostatic system activation is implicated in various chronic diseases, but its role in progressive renal failure requires further elucidation.

Purpose of the Study:

  • To investigate haemostatic activation in patients with non-diabetic CRF and diabetic nephropathy.
  • To determine the relationship between specific haemostatic markers and the rate of renal function decline in these patient groups.

Main Methods:

  • Comparison of haemostatic markers (D dimer, vWFAg, CRP, platelet aggregation, platelet factor 4, serum TxB2) between patients and healthy controls.
  • Multiple regression analysis to identify independent predictors of renal failure progression.

Main Results:

  • Both patient groups exhibited significantly elevated D dimer, vWFAg, and CRP, along with increased spontaneous platelet aggregation compared to controls.
  • Proteinuria was independently associated with the rate of progression in both non-diabetic CRF and diabetic nephropathy.
  • Serum TxB2 independently predicted progression in non-diabetic CRF, while vWFAg independently predicted progression in diabetic nephropathy.

Conclusions:

  • Haemostatic activation is present in progressive non-diabetic and diabetic renal failure.
  • Proteinuria, serum TxB2, and vWFAg are significant determinants of renal failure progression and may hold prognostic value.

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