title: Intraperitoneal hypercoagulation and hypofibrinolysis is present in childhood peritonitis.
abstract: An increased rate of obstruction of peritoneal dialysis catheters is observed during peritonitis. Hypercoagulation and hypofibrinolysis may explain this increased occurrence. We studied plasminogen activator inhibitor type 1 antigen (PAI-1), tissue-type plasminogen activator antigen (t-PA), D-dimer (DD), plasmin-alpha2-antiplasmin complexes (PAP), and thrombin-antithrombin III complexes (TAT) in 7 children with peritonitis (group A) and 12 children during stable peritoneal dialysis (group B). Albumin, beta2-microglobulin, IgG, and alpha2-macroglobulin were measured for baseline transperitoneal protein transport. After a dwell of 6 h with 1.36% Dianeal, dialysate and serum samples were collected. Dialysate to plasma ratios of all proteins were calculated. During peritonitis (group A) TAT was higher: 34.7 versus 22.0 (P=0.01). PAI-1 was increased in group A: 76.5 versus 22.9 (P=0.004). PAP was decreased during peritonitis (group A): 24.9 versus 39.3 (P=0.01). In group A, DD were decreased. 10.8 versus 26.7 (P=0.002). t-PA was similar in both groups (23.7 in group A vs. 27.7 in group B; P=0.26). In both groups TAT, PAI-1, t-PA, PAP, and DD were significantly higher than in baseline transperitoneal transport, suggesting intraperitoneal production. Hypercoagulability and hypofibrinolysis were present during peritonitis compared with the control situation.
authors.affiliation: Department of Pediatrics, University Hospital Nijmegen, The Netherlands.
authors.forename: A W
authors.initials: AW
authors.lastname: de Boer
authors.forename: M
authors.initials: M
authors.lastname: Levi
authors.forename: R E
authors.initials: RE
authors.lastname: Reddingius
authors.forename: J L
authors.initials: JL
authors.lastname: Willems
authors.forename: S
authors.initials: S
authors.lastname: van den Bosch
authors.forename: C H
authors.initials: CH
authors.lastname: Schröder
authors.forename: L A
authors.initials: LA
authors.lastname: Monnens
mesh_terms: D000293:Adolescent; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000295:instrumentation; D010538:Peritonitis / Q000097:blood* / Q000209:etiology; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D012709:Serum Albumin / Q000032:analysis; D000511:alpha-Macroglobulins / Q000032:analysis
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D012709:Serum Albumin; D000511:alpha-Macroglobulins