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Does hypernatraemia promote thrombosis?

P J Grant, G M Tate, J R Hughes

    Thrombosis Research
    |November 1, 1985
    PubMed
    Summary
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    Hypernatraemia, or high sodium levels, increases thrombosis risk. This study shows hypernatraemia and vasopressin elevate clotting factors, potentially explaining associated thrombo-embolic complications.

    Area of Science:

    • Physiology
    • Hematology
    • Endocrinology

    Background:

    • Hypernatraemic states are linked to an increased risk of thrombosis.
    • The specific roles of sodium and vasopressin in this hypercoagulable state require elucidation.

    Purpose of the Study:

    • To investigate the effects of hypertonic saline infusion on hemostatic function in healthy male volunteers.
    • To examine the relative contributions of sodium and arginine vasopressin (aVP) to hypercoagulability.

    Main Methods:

    • Infusion of hypertonic saline in 11 male volunteers.
    • Measurement of plasma osmolality, arginine vasopressin (aVP) concentrations, factor VIII (FVIII), euglobulin clot lysis time (ELT), and fibrinopeptide A (FPA) generation.
    • Serial blood sampling during and after saline infusion.

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    Main Results:

    • Plasma osmolality and aVP concentrations significantly increased during hypertonic saline infusion.
    • Plasminogen activator activity, measured by ELT, significantly increased, correlating strongly with plasma osmolality.
    • Fibrinopeptide A generation time shortened, indicating accelerated coagulation, though statistical significance was not consistently met for all measures.

    Conclusions:

    • Hypernatraemia and elevated plasma aVP concentrations induce hemostatic changes consistent with a hypercoagulable state.
    • These hemostatic alterations may contribute to the thrombo-embolic complications observed in conditions like hyperosmolar coma and severe heatstroke.
    • The precise mechanisms underlying these observed hemostatic changes remain to be fully clarified.