[Vessel-platelet and coagulation components of hemostasis in patients with chronic tubulointerstitial nephritis].
OBJECTIVE
To study vessel-platelet and coagulation parts of hemostasis system, their correlation with clinical characteristics and activity of chronic tubulointerstitial nephritis (CTIN).


METHODS
128 patients 15 to 65 years of age with CTIN were included in the study. The diagnosis was confirmed morphologically in 42 patients. The patients were divided into subgroups by activity of the disease at the moment of examination (active and inactive CTIN), by arterial pressure (normotensive and hypertensive patients), intact and low renal function, by duration of the disease (up to 60 months, 61-120 months, more than 120 months). Complex study of hemostasis system was carried out by a set of standard techniques.


RESULTS
CTIN runs with activation of vessel-platelet hemostasis characterised by a decrease in platelets count (p < 0.001), persistent platelet hyperaggregation and activation (p < 0.001). Severity of platelet aggregative activity is related with endothelial affection manifesting with high level and activity of Willebrand factor (p < 0.001). The most typical changes of coagulation in CTIN were acceleration of activated partial thrombin time (p < 0.001) closely related with activation of thrombocytic hemostasis and background thrombinemia the presence of which was confirmed by elevated blood level of soluble fibrin-monomeric complexes (SFMC).


CONCLUSIONS
Hypercoagulation, suppression of fibrinolytic plasma activity, increase of SFMC and fibrinogen levels in the blood as well as detected enhancement of platelet aggregation testify to a latent course of renal intravascular blood coagulation in CTIN. Hemostasis system activation in CTIN helps assessment of the disease activity.
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TS
Suvorova
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Tov
E A
EA
Movchan
D000293:Adolescent; D000328:Adult; D000368:Aged; D001777:Blood Coagulation / Q000502:physiology*; D001792:Blood Platelets / Q000502:physiology*; D002908:Chronic Disease; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000097:blood* / Q000150:complications / Q000473:pathology; D010974:Platelet Aggregation / Q000502:physiology*; D010976:Platelet Count; D011379:Prognosis; D012307:Risk Factors; D019851:Thrombophilia / Q000097:blood / Q000150:complications; D013997:Time Factors; D014841:von Willebrand Factor / Q000378:metabolism
D014841:von Willebrand Factor