Oxidative stress effects fibrinolytic system in dialysis uraemic patients.
BACKGROUND
Enhanced oxidative stress (SOX) and changes in the fibrinolytic system are common in end-stage renal failure patients undergoing maintenance dialysis. This study attempted to verify the existence of a relationship between SOX documented by Cu/Zn superoxide dismutase (Cu/Zn SOD) and fibrinolysis analyzed by tissue-type plasminogen activator (tPA), urokinase-type plasminogen activator (uPA), plasminogen activator inhibitor 1 (PAI-1) and plasmin/antiplasmin (PAP) complexes in dialysis patients.


METHODS
Twenty-seven patients on maintenance haemodialysis (HD) and 16 on maintenance peritoneal dialysis (CAPD) were examined together with 18 healthy controls. Pre-dialysis blood levels of all the parameters were determined using commercially ELISA kits.


RESULTS
Cu/Zn SOD, uPA and PAP levels were increased in both groups of dialyzed patients compared to the controls. PAI-1 was significantly lower in CAPD subjects compared to HD subjects and control group. PAI-1/uPA ratio and PAI-1/tPA ratio were significantly decreased in CAPD and HD compared to controls, being significantly lower in CAPD patients relative to HD patients. In the patients, increased Cu/Zn SOD levels directly correlated with those of uPA (r=0.565, p<0.0001) and PAP (r=0.335, p<0.05); the fibrinolytic markers were also positively associated with each other (r=0.377, p<0.05).


CONCLUSIONS
The positive association between Cu/Zn SOD and both uPA as well as PAP levels suggests a link between SOX and the fibrinolytic activity in dialysis patients. We hypothesize that increased SOX-mediated fibrinolytic activity may be a part of the counter-system against activation of blood coagulation in these patients.
Pawlak
Krystyna
K
Department of Nephrology and Clinical Transplantation, Medical University of Bialystok, 14 Zurawia St., 15-540 Bialystok, Poland. krystynapawlak@poczta.onset.pl
Pawlak
Dariusz
D
Mysliwiec
Michal
M
D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005341:Fibrinolysin / Q000032:analysis; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D010531:Peritoneal Dialysis, Continuous Ambulatory; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D012016:Reference Values; D006435:Renal Dialysis / Q000379:methods; D013482:Superoxide Dismutase / Q000097:blood*; D014511:Uremia / Q000097:blood / Q000503:physiopathology* / Q000628:therapy; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood; D000979:alpha-2-Antiplasmin / Q000032:analysis
D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D000979:alpha-2-Antiplasmin; D013482:Superoxide Dismutase; D005341:Fibrinolysin; D014568:Urokinase-Type Plasminogen Activator