Increased intraglomerular thrombin formation in diabetic microangiopathy.
Estimations of soluble fibrin monomer complexes (SFMC) in plasma are a convenient index of thrombin activation. Renal venous-arterial differences in plasma SFMC concentrations were determined in 16 randomly chosen diabetic patients by sampling directly and simultaneously from the renal artery and vein according to the method of Seldinger. In all subjects, SFMC concentrations were higher in the renal vein than in the renal artery, indicating that the kidney is an important source of SFMC. Venous-arterial differences were markedly elevated in patients with severe renal and retinal microangiopathy coupled with hypertension. The hypothesis is advanced that elevated plasma SFMC levels lead to abnormal fibrin deposits in lesioned glomeruli and retinal vessels. It is postulated that plasma SFMC may be a useful parameter for the assessment of diabetic vascular complications.
Second Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan.
H
H
Tada
K
K
Kuboki
Y
Y
Oshima
S
S
Takeuchi
S
S
Isogai
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D003925:Diabetic Angiopathies / Q000097:blood / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000097:blood / Q000503:physiopathology; D005260:Female; D005337:Fibrin / Q000378:metabolism; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007678:Kidney Glomerulus / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000503:physiopathology; D012082:Renal Veins / Q000503:physiopathology; D013917:Thrombin / Q000096:biosynthesis*
D005337:Fibrin; D005340:Fibrinogen; D013917:Thrombin