Terminal Phase Components of the Clotting Cascade in Patients with End-Stage Renal Disease Undergoing Hemodiafiltration or Hemodialysis Treatment
Hemostasis disorder in patients with end-stage renal disease (ESRD) is frequently associated with bleeding diathesis but it may also manifest in thrombotic complications. Analysis of individual coagulation and fibrinolytic factors may shed light on the background of this paradox situation. Here we e...
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| Format: | Article |
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MDPI AG
2020-11-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/21/22/8426 |
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| author | Krisztina Pénzes Boglárka Hurják Éva Katona Gergely Becs József Balla László Muszbek |
| author_facet | Krisztina Pénzes Boglárka Hurják Éva Katona Gergely Becs József Balla László Muszbek |
| author_sort | Krisztina Pénzes |
| collection | DOAJ |
| description | Hemostasis disorder in patients with end-stage renal disease (ESRD) is frequently associated with bleeding diathesis but it may also manifest in thrombotic complications. Analysis of individual coagulation and fibrinolytic factors may shed light on the background of this paradox situation. Here we explored components essential for fibrin formation/stabilization in ESRD patients being on maintenance hemodiafiltration (HDF) or hemodialysis (HD). Pre-dialysis fibrinogen, factor XIII (FXIII) antigen concentrations and FXIII activity were elevated, while α<sub>2</sub>-plasmin inhibitor (α<sub>2</sub>PI) activity decreased. The inflammatory status, as characterized by C-reactive protein (CRP) was a key determinant of fibrinogen concentration, but not of FXIII and α<sub>2</sub>PI levels. During a 4-h course of HDF or HD, fibrinogen concentration and FXIII levels gradually elevated. When compensated for the change in plasma water, i.e., normalized for plasma albumin concentration, only FXIII elevation remained significant. There was no difference between HDF and HD treatments. Individual HDF treatment did not influence α<sub>2</sub>PI activity, however after normalization it decreased significantly. HD treatment had a different effect, α<sub>2</sub>PI activities became elevated but the elevation disappeared after normalization. Elevated fibrinogen and FXIII levels in ESRD patients might contribute to the increased thrombosis risk, while decreased α<sub>2</sub>PI activity might be associated with elevated fibrinolytic potential. |
| first_indexed | 2024-03-10T14:58:38Z |
| format | Article |
| id | doaj.art-379f2a33abcd4ad68c4170d05e58f7d7 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-10T14:58:38Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-379f2a33abcd4ad68c4170d05e58f7d72023-11-20T20:23:20ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672020-11-012122842610.3390/ijms21228426Terminal Phase Components of the Clotting Cascade in Patients with End-Stage Renal Disease Undergoing Hemodiafiltration or Hemodialysis TreatmentKrisztina Pénzes0Boglárka Hurják1Éva Katona2Gergely Becs3József Balla4László Muszbek5Division of Clinical Laboratory Science, Department of Laboratory Medicine, University of Debrecen, Faculty of Medicine, H-4032 Debrecen, HungaryDivision of Clinical Laboratory Science, Department of Laboratory Medicine, University of Debrecen, Faculty of Medicine, H-4032 Debrecen, HungaryDivision of Clinical Laboratory Science, Department of Laboratory Medicine, University of Debrecen, Faculty of Medicine, H-4032 Debrecen, HungaryDepartment of Nephrology, University of Debrecen, Faculty of Medicine, H-4032 Debrecen, HungaryDepartment of Nephrology, University of Debrecen, Faculty of Medicine, H-4032 Debrecen, HungaryDivision of Clinical Laboratory Science, Department of Laboratory Medicine, University of Debrecen, Faculty of Medicine, H-4032 Debrecen, HungaryHemostasis disorder in patients with end-stage renal disease (ESRD) is frequently associated with bleeding diathesis but it may also manifest in thrombotic complications. Analysis of individual coagulation and fibrinolytic factors may shed light on the background of this paradox situation. Here we explored components essential for fibrin formation/stabilization in ESRD patients being on maintenance hemodiafiltration (HDF) or hemodialysis (HD). Pre-dialysis fibrinogen, factor XIII (FXIII) antigen concentrations and FXIII activity were elevated, while α<sub>2</sub>-plasmin inhibitor (α<sub>2</sub>PI) activity decreased. The inflammatory status, as characterized by C-reactive protein (CRP) was a key determinant of fibrinogen concentration, but not of FXIII and α<sub>2</sub>PI levels. During a 4-h course of HDF or HD, fibrinogen concentration and FXIII levels gradually elevated. When compensated for the change in plasma water, i.e., normalized for plasma albumin concentration, only FXIII elevation remained significant. There was no difference between HDF and HD treatments. Individual HDF treatment did not influence α<sub>2</sub>PI activity, however after normalization it decreased significantly. HD treatment had a different effect, α<sub>2</sub>PI activities became elevated but the elevation disappeared after normalization. Elevated fibrinogen and FXIII levels in ESRD patients might contribute to the increased thrombosis risk, while decreased α<sub>2</sub>PI activity might be associated with elevated fibrinolytic potential.https://www.mdpi.com/1422-0067/21/22/8426α<sub>2</sub>-plasmin inhibitorend-stage renal diseasefactor XIIIfibrinogenhemodiafiltrationhemodialysis |
| spellingShingle | Krisztina Pénzes Boglárka Hurják Éva Katona Gergely Becs József Balla László Muszbek Terminal Phase Components of the Clotting Cascade in Patients with End-Stage Renal Disease Undergoing Hemodiafiltration or Hemodialysis Treatment International Journal of Molecular Sciences α<sub>2</sub>-plasmin inhibitor end-stage renal disease factor XIII fibrinogen hemodiafiltration hemodialysis |
| title | Terminal Phase Components of the Clotting Cascade in Patients with End-Stage Renal Disease Undergoing Hemodiafiltration or Hemodialysis Treatment |
| title_full | Terminal Phase Components of the Clotting Cascade in Patients with End-Stage Renal Disease Undergoing Hemodiafiltration or Hemodialysis Treatment |
| title_fullStr | Terminal Phase Components of the Clotting Cascade in Patients with End-Stage Renal Disease Undergoing Hemodiafiltration or Hemodialysis Treatment |
| title_full_unstemmed | Terminal Phase Components of the Clotting Cascade in Patients with End-Stage Renal Disease Undergoing Hemodiafiltration or Hemodialysis Treatment |
| title_short | Terminal Phase Components of the Clotting Cascade in Patients with End-Stage Renal Disease Undergoing Hemodiafiltration or Hemodialysis Treatment |
| title_sort | terminal phase components of the clotting cascade in patients with end stage renal disease undergoing hemodiafiltration or hemodialysis treatment |
| topic | α<sub>2</sub>-plasmin inhibitor end-stage renal disease factor XIII fibrinogen hemodiafiltration hemodialysis |
| url | https://www.mdpi.com/1422-0067/21/22/8426 |
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