title: Atherosclerotic and hemostatic abnormalities in patients undergoing hemodialysis.
abstract: Vascular events caused by atherosclerosis are the major cause of death in patients undergoing hemodialysis (HD). The relationship between the tests of atherosclerosis and hemostasis in 84 patients with HD was examined. Abnormal test results indicting the occurrence of atherosclerosis were found in 66% by the Fontaine score, in 33% by ankle blood pressures, and in 79% by aortic calcification index (ACI). When HD was prolonged, the mean Fontaine score and ACI were further increased. Particularly, the ACI tended to correlate with HD duration. The ankle-brachial index (ABI) was decreased in patients with HD duration of more than 10 years. Before HD, the plasma levels of fibrinogen, plasmin-plasmin inhibitor complex (PIC), thrombomodulin (TM), and D-dimer were increased, while the plasma levels of protein C (PC), antithrombin (AT), thrombin-antithrombin complex (TAT), and tissue plasminogen activator (tPA)-plasminogen activator inhibitor-I (PAI-I) complex (tPA-PAI-1 complex) were decreased. With prolonged HD, the plasma levels of AT and PC were decreased, while those of D-dimer were increased. The plasma levels of TAT and TPA-PAI-1 complex were significantly increased and those of PIC, soluble fibrin (SF) and D-dimer tended to be high in patients with less than 0.7 of ABI. The plasma levels of D-dimer, TPA-PAI-1 complex, TAT, PIC, and SF tended to be high in patients with more than 0.5 in ABI. These findings suggest that patients undergoing HD have progressive atherosclerosis and that this is associated with some hemostatic abnormalities.
authors.affiliation: Second Department of Internal Medicine, Mie University School of Medicine, Tsu-City, Mie-ken, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kushiya
authors.forename: Hideo
authors.initials: H
authors.lastname: Wada
authors.forename: Miho
authors.initials: M
authors.lastname: Sakakura
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Mori
authors.forename: Esteban C
authors.initials: EC
authors.lastname: Gabazza
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Nishikawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nobori
authors.forename: Mitsuya
authors.initials: M
authors.lastname: Noguchi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Izumi
authors.forename: Hirosi
authors.initials: H
authors.lastname: Shiku
mesh_terms: D000368:Aged; D001161:Arteriosclerosis / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006487:Hemostasis; D020141:Hemostatic Disorders / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time; D006435:Renal Dialysis / Q000009:adverse effects* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D015415:Biomarkers