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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of

Ruth Dubin1, Mary Cushman, Aaron R Folsom

  • 1Department of Medicine, Division Nephrology, University of California San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143-0532, USA. ruth.dubin@ucsf.edu

BMC Nephrology
|January 29, 2011
PubMed

Insights

Reduced kidney function (eGFR < 60) is linked to higher levels of blood clotting markers (hemostasis). This dysregulation may explain the increased cardiovascular risk associated with chronic kidney disease (CKD).

Area of Science:

  • Nephrology and Cardiovascular Research
  • Hemostasis and Thrombosis
  • Epidemiology of Chronic Diseases

Background:

  • Chronic kidney disease (CKD), defined by estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, is a significant independent risk factor for cardiovascular and overall mortality.
  • A potential link between impaired kidney function and hemostatic system abnormalities was hypothesized.

Purpose of the Study:

  • To investigate the association between reduced kidney function (eGFR) and various hemostatic markers.
  • To explore potential mechanisms linking CKD to increased cardiovascular risk through hemostatic dysregulation.

Main Methods:

  • Cross-sectional analysis of 6751 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with a wide range of kidney function.
  • Kidney function assessed using cystatin C (eGFRcys) and creatinine (eGFRcr).
  • Measured hemostatic markers included sTM, sTF, D-Dimer, vWF, Factor VIII, PAP, TFPI, PAI-1, and fibrinogen, analyzed via multivariable linear regression.

Main Results:

  • Participants with lower eGFRcys (< 60 ml/min/1.73 m2) exhibited significantly higher adjusted levels of multiple hemostatic markers compared to those with eGFRcys >90.
  • Elevated levels were observed for sTM (86%), sTF (68%), D-Dimer (44%), PAP (22%), Factor VIII (17%), TFPI (15%), vWF (12%), and fibrinogen (6%).
  • Similar trends were noted for individuals with moderate kidney dysfunction (eGFRcys 60-90), with no significant differences when categorized by eGFRcr.

Conclusions:

  • A consistent association exists between lower eGFR and elevated hemostatic marker levels across a broad spectrum of kidney function.
  • Dysregulation of the hemostatic system is a potential contributing mechanism for the heightened cardiovascular risk observed in individuals with reduced kidney function.
Abstract

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