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Vascular endothelial dysfunction in patients on regular dialysis treatment
M Nakayama1, K Yamada, Y Yamamoto
1Tokyo Jikei University School of Medicine, Second Department of Internal Medicine, Japan.
Clinical Nephrology
|August 1, 1994
Summary
Patients on regular dialysis treatment (RDT) show signs of vascular endothelial damage. Elevated circulating immunoreactive thrombomodulin (i-TM) and reduced tissue plasminogen activator (tPA) release indicate this damage.
Area of Science:
- Vascular Biology
- Nephrology
- Biomarkers
Background:
- Circulating plasma immunoreactive thrombomodulin (i-TM) is a marker of vascular endothelial injury.
- Desmopressin is known to stimulate the release of tissue plasminogen activator (tPA) from the endothelium.
Purpose of the Study:
- To estimate vascular endothelial damage in patients undergoing regular dialysis treatment (RDT).
- To assess basal plasma levels of i-TM and the capacity for tPA release in RDT patients.
Main Methods:
- Measured basal plasma i-TM and tPA levels in RDT patients and healthy controls.
- Assessed the tPA release response to desmopressin administration in both groups.
- Correlated i-TM levels with tPA release capacity.
Main Results:
- RDT patients exhibited significantly higher basal plasma i-TM levels compared to controls (p < 0.001).
- Basal plasma tPA levels were significantly lower in RDT patients (p < 0.05).
- Desmopressin-induced tPA release was significantly reduced in RDT patients (p < 0.001), with an inverse correlation between i-TM levels and tPA increments (p < 0.05, r = -0.75).
Conclusions:
- The findings suggest significant vascular endothelial damage in patients on RDT.
- Elevated i-TM and impaired tPA release serve as indicators of endothelial dysfunction in this population.