Fibrin clot structure in patients with end-stage renal disease

Jonas A. Sjøland; Johannes J. Sidelmann; Mikkel Brabrand; Robert S. Pedersen; Jørgen H. Pedersen; Kim Esbensen; Kristina F. Standeven; Robert A. S. Ariëns; Jørgen Gram

doi:10.1160/TH06-12-0715

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2007; 98(02): 339-345
DOI: 10.1160/TH06-12-0715

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Fibrin clot structure in patients with end-stage renal disease

Jonas A. Sjøland

¹Dept. of Clinical Biochemistry, Ribe County Hospital, Esbjerg, Denmark

²Dept. for Thrombosis Research, Institute of Public Health, University of Southern Denmark,Denmark

,

Johannes J. Sidelmann

¹Dept. of Clinical Biochemistry, Ribe County Hospital, Esbjerg, Denmark

²Dept. for Thrombosis Research, Institute of Public Health, University of Southern Denmark,Denmark

,

Mikkel Brabrand

³Dept. of Nephrology, Ribe County Hospital, Esbjerg, Denmark

,

Robert S. Pedersen

³Dept. of Nephrology, Ribe County Hospital, Esbjerg, Denmark

,

Jørgen H. Pedersen

⁴Esbjerg Technical Institute, Aalborg University Esbjerg, Denmark

,

Kim Esbensen

⁵ACABS, Aalborg University Esbjerg, Denmark

,

Kristina F. Standeven

⁶Academic Unit of Molecular Vascular Medicine, University of Leeds, UK

,

Robert A. S. Ariëns

⁶Academic Unit of Molecular Vascular Medicine, University of Leeds, UK

,

Jørgen Gram

¹Dept. of Clinical Biochemistry, Ribe County Hospital, Esbjerg, Denmark

²Dept. for Thrombosis Research, Institute of Public Health, University of Southern Denmark,Denmark

› Institutsangaben

Abstract

Summary

Fibrin clots with reduced permeability, increased clot stiffness and reduced fibrinolysis susceptibility may predispose to cardiovascular disease (CVD). Little is known, however, about the structure of fibrin clots in patients with end-stage renal disease (ESRD).These patients suffer from a high risk of CVD in addition to their chronic low-grade inflammation. Using permeability, compaction and turbidity studies in 22 ESRD patients and 24 healthy controls, fibrin clots made from patient plasma were found to be less permeable (p<0.001), less compactable (p<0.001), and less susceptible to fibrinolysis (p<0.001) than clots from controls.The maximum rate of turbidity increase was also higher for the patients than controls (p<0.001), and scan-ning electron microscopy revealed higher clot density of fibrin fibers in clots from patients than clots from controls (p<0.001). Patients had higher plasma concentrations of fibrinogen, C-reative protein and interleukin 6 than controls.These plasma markers of inflammation correlated significantly with most of the fibrin structure characteristics observed in the patients. In contrast, plasma markers of azothemia showed no such correlations. The results suggest that in ESRD patients fibrin clots are significantly different from healthy controls, and that the fibrin structure characteristics in the patients are associated primarily with the inflammatory plasma milieu rather than with level of azothemia.

Keywords

Fibrinogen - fibrinolysis - azothemia - inflammation

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Referenzen

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