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Variations of protein C in uremic hemodialysed patients
P Nguyen1, O Toupance, J Chanard
1Laboratoire central d'Hématologie, CHU, Reims.
Insights
Protein C anticoagulant activity is often impaired in end-stage renal disease patients. Hemodialysis improves Protein C levels, with no interference from heparin, suggesting a potential benefit for these patients.
Area of Science:
- Nephrology
- Hematology
- Clinical Chemistry
Background:
- Protein C is a crucial anticoagulant.
- End-stage renal disease (ESRD) may affect coagulation.
- Protein C function in ESRD requires further investigation.
Purpose of the Study:
- To assess Protein C levels and activity in ESRD patients.
- To compare Protein C with other coagulation inhibitors.
- To evaluate the impact of hemodialysis on Protein C.
Main Methods:
- Measured Protein C using antigenic, amidolytic, and chronometric assays.
- Analyzed 27 ESRD patients before and after hemodialysis.
- Compared Protein C with antithrombin III, protein S, and fibrinolytic parameters.
Main Results:
- Impaired Protein C anticoagulant activity found in 8/27 patients at baseline.
- Hemodialysis increased Protein C activity and antigen levels.
- No interference from heparin on chronometric Protein C measurement was observed.
Conclusions:
- Protein C deficiency is present in some ESRD patients.
- Hemodialysis positively impacts Protein C levels and activity.
- Further research is needed to understand the clinical significance of these findings.
Abstract:
Protein C has been measured by three different assays (antigenic, amidolytic and chronometric) in 27 end-stage renal insufficient patients before and after hemodialysis. Protein C levels have been compared with other coagulation inhibitors (antithrombin III, protein S) and fibrinolytic parameters. Baseline anticoagulant activity of protein C has been found impaired in eight cases whereas other inhibitors were normal. In four cases, both anticoagulant and antigenic levels were low. In one case, amidolytic method could also found a low activity. Hemodialysis leads to an increase of protein C activity and antigen level. Heparinemia after hemodialysis does not interfere with the chronometric measurement of protein C anticoagulant activity. Total protein level, hematocrit, protein S and antithrombin III are also elevated after hemodialysis. Baseline fibrinolytic parameters are normal and remain unchanged after hemodialysis. The clinical relevance of such modifications is discussed.