Related Experiment Videos
Coagulation cascade, fibrinolytic system, antithrombin III, protein C and protein S in patients maintained on
N D Vaziri1, G M Shah, R L Winer
1Department of Medicine, University of California, Irvine 92717.
Insights
Patients on continuous ambulatory peritoneal dialysis (CAPD) show increased levels of clotting factors and protein S. However, key anticoagulants and fibrinolytic agents remain unchanged, suggesting potential hemostatic alterations in CAPD patients.
Area of Science:
- Nephrology
- Hematology
- Clinical Chemistry
Background:
- End-stage renal disease (ESRD) impacts hemostasis.
- Continuous ambulatory peritoneal dialysis (CAPD) is a common ESRD treatment.
- Understanding coagulation and fibrinolysis in CAPD patients is crucial.
Purpose of the Study:
- To investigate the coagulation cascade, fibrinolytic system, and natural anticoagulants in CAPD patients.
- To compare hemostatic markers in CAPD patients versus healthy volunteers.
Main Methods:
- Studied 14 CAPD patients and 10 healthy controls.
- Assessed plasma procoagulant activities of multiple coagulation factors (XII, XI, IX, VIII, VII, X, II, V).
- Measured plasma concentrations of total and free protein S, fibrinogen, factor VIII-related antigen, protein C, antithrombin III, plasminogen, and alpha 2-antiplasmin.
Main Results:
- Significantly elevated plasma procoagulant activities for factors XII, XI, IX, VIII, VII, X, and II in CAPD patients.
- Increased plasma concentrations of total and free protein S, fibrinogen, and factor VIII-related antigen in CAPD patients.
- No significant differences in plasma levels of protein C, antithrombin III, plasminogen, or alpha 2-antiplasmin between groups.
Conclusions:
- CAPD patients exhibit a tendency towards increased levels of several coagulation factors and protein S.
- Fibrinolytic and endogenous anticoagulant systems (antithrombin III, protein C) appear unaltered in CAPD patients.
- The clinical significance and underlying mechanisms of these hemostatic changes warrant further investigation.
Abstract:
We studied the coagulation cascade, fibrinolytic system and naturally occurring anticoagulants in a group of 14 patients with end-stage renal disease maintained on continuous ambulatory peritoneal dialysis (CAPD). The results were compared with those obtained in a group of ten normal volunteers. Plasma procoagulant activities of factors XII, XI, IX, VIII, VII, X and II were significantly greater in the CAPD group as compared to the normal control group. Likewise plasma concentrations of total and free protein S were increased in the CAPD group. Although the mean value for plasma factor V activity in the CAPD group was higher than that found in the control group the difference did not attain statistical significance. In addition plasma fibrinogen concentration and factor VIII-related antigen level were significantly increased in CAPD patients. No significant difference was found between the CAPD patients and the control group with respect to plasma levels of protein C, antithrombin III, plasminogen or alpha 2-antiplasmin. In summary, the results demonstrate a tendency for increased levels of various coagulation factors and protein S in CAPD patients with no significant alterations in the levels of various fibrinolytic and endogenous anticoagulant agents, i.e. antithrombin III and protein C. The clinical significance and the mechanism responsible for the observed changes require further investigation.