| Altered fibrin clot properties in patients on long-term haemodialysis: relation to cardiovascular mortality. | |
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MedLine Citation:
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PMID: 18156458 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Haemodialysis patients are at an increased risk of cardiovascular (CV) morbidity and mortality. Both end-stage renal disease (ESRD) and thromboembolic coronary events have been shown to be associated with the formation of dense fibrin clots resistant to fibrinolysis. The aim of the present study was to investigate the effect of long-term haemodialysis on clot structure/function and analyse an influence of markers of inflammation, oxidative stress and lipoprotein(a). We sought also to investigate if clot features might be related to CV events and mortality in haemodialysis patients. Subjects and methods. In 33 patients (19 males, 14 females), aged 27 to 89 years, on long-term haemodialysis and 33 age- and sex-matched apparently healthy controls, we investigated fibrin clot properties and susceptibility to lysis using recombinant tissue plasminogen activator by using permeation and turbidity assays. RESULTS: Haemodialysis patients produced fibrin clots that had less porous structure (P < 0.0001) were less susceptible to fibrinolysis (P < 0.0001), began fibrin protofibril formation more quickly (P < 0.0001) and showed increased overall fibre thickness (P < 0.0001) compared with controls. Clot permeability and lysis time correlated with F2-isoprostanes (P < 0.01), Lp(a) (P < 0.0001) and fibrinogen (P < 0.01). None of the clot variables showed associations with the duration of haemodialysis treatment or the cause of ESRD. During a 36-month follow-up, 10 CV deaths were recorded. Mortality was associated with reduced clot permeability (P < 0.0001), prolonged lysis time (P < 0.0001), faster fibrin protofibril formation (P = 0.0004), thicker fibres (P < 0.0001) and increased fibrin clot mass (P < 0.0001). CONCLUSIONS: Unfavourably altered clot properties can be detected in haemodialysis patients and may be associated with increased CV mortality. |
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Authors:
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Anetta Undas; Marek Kolarz; Grzegorz Kopeć; Wiesława Tracz |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-12-21 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 23 ISSN: 1460-2385 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-21 Completed Date: 2008-07-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 2010-5 Citation Subset: IM |
Affiliation:
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Institute of Cardiology, Jagiellonian University School of Medicine, Cracow, Poland. mmundas@cyf-kr.edu.pl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Blood Coagulation / drug effects, physiology Cardiovascular Diseases / etiology, mortality Case-Control Studies Cohort Studies Coronary Thrombosis / etiology*, mortality*, physiopathology Female Fibrin / drug effects, metabolism* Fibrin Fibrinogen Degradation Products / metabolism Fibrinolytic Agents / administration & dosage Humans Kidney Failure, Chronic / blood, mortality, therapy* Long-Term Care Male Middle Aged Nephelometry and Turbidimetry Permeability Probability Reference Values Renal Dialysis / adverse effects*, methods Risk Assessment Statistics, Nonparametric Survival Analysis |
| Chemical | |
Reg. No./Substance:
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0/Fibrin Fibrinogen Degradation Products; 0/Fibrinolytic Agents; 9001-31-4/Fibrin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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