Document Detail

Plasma and platelet von Willebrand factor abnormalities in patients with uremia: lack of correlation with uremic bleeding.
MedLine Citation:
PMID:  11292197     Owner:  NLM     Status:  MEDLINE    
Chronic renal failure often is associated with abnormal bleeding that may represent an important complication of this disorder. The hemorrhagic tendency currently is attributed to altered primary hemostasis, mainly platelet dysfunction. However, von Willebrand factor (vWF) also seems to be involved, even though the nature of its abnormalities is still controversial. To gain insight into the role of vWF in determining uremic bleeding, we studied 11 patients with stable, chronic renal failure. We found a significant increase in plasma factor VIII (FVIII), vWF:antigen (Ag), and vWF:ristocetin cofactor (Rco) levels, associated with a mean decrease in platelet vWF:Ag. Plasma vWF multimer pattern was characterized by increased representation of all oligomers in all patients, but five patients also showed a slight decrease in large vWF multimers. In addition, platelet vWF multimer pattern displayed a decrease in all components, especially those with high molecular weight. Despite normal bleeding time, collagen-induced platelet aggregation was defective in almost all patients, whereas vWF collagen binding capacity was normal. The levels of glycocalicin, the circulating fragment of glycoprotein Ib-IX, the major platelet vWF receptor, were also normal. In six patients who also were studied after initiation of dialysis, collagen-induced platelet aggregation was impaired further. Moreover, plasma vWF, and especially FVIII levels, were increased additionally, in association with a normalized platelet vWF content and an improved vWF multimer pattern. The results suggest that vWF abnormalities are present in uremia. Moreover, thrombopathy caused by impaired collagen-induced platelet aggregation is constantly present and apparently not improved by dialytic treatment.
A Casonato; E Pontara; U P Vertolli; A Steffan; C Durante; L De Marco; F Sartorello; A Girolami
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis     Volume:  7     ISSN:  1076-0296     ISO Abbreviation:  Clin. Appl. Thromb. Hemost.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-06     Completed Date:  2001-08-23     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  9508125     Medline TA:  Clin Appl Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-6     Citation Subset:  IM    
University of Padua Medical School, Department of Medical and Surgery Sciences, Second Chair of Internal Medicine, Padua, Italy.
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MeSH Terms
Blood Platelets / chemistry,  metabolism
Case-Control Studies
Hemorrhage / etiology
Middle Aged
Molecular Weight
Platelet Aggregation Inhibitors / metabolism
Platelet Function Tests
Platelet Glycoprotein GPIb-IX Complex / metabolism
Renal Dialysis
Uremia / blood*,  complications
von Willebrand Diseases / blood*,  complications
von Willebrand Factor / metabolism*
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIb-IX Complex; 0/glycocalicin; 0/von Willebrand Factor

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