title: Hypercoagulability and cardiovascular disease in diabetic nephropathy.
abstract: Diabetic nephropathy is the leading cause of end stage renal disease (ESRD) and an important risk factor for cardiovascular disease. Recent studies have shown that increased plasma levels of Von Willebrand factor (VWF) and reduced plasma levels of enzyme ADAMTS13 are associated with diabetic nephropathy and an increased risk of developing cardiovascular disease, suggesting that these markers of hypercoagulability may contribute to an increased risk of cardiovascular disease in diabetic patients with impaired renal function. However, it is still not clear whether VWF and ADAMTS13 are only markers of cardiovascular events or whether they play an active role in the development of these events. It is also unclear how renal injury may affect ADAMTS13 levels, leading consequently to hypercoagulability. The association of diabetic nephropathy, atherosclerotic cardiovascular disease and these hypercoagulability markers is discussed in this review. Insights on the role that renal dysfunction and other possible mechanisms may have in ADAMTS13 metabolism, leading to reduced levels of this enzyme and increased hypercoagulability are also presented.
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. caroldomingueti@yahoo.com.br
authors.forename: Caroline Pereira
authors.initials: CP
authors.lastname: Domingueti
authors.forename: Luci Maria Sant'Ana
authors.initials: LM
authors.lastname: Dusse
authors.forename: Maria das Graças
authors.initials: Md
authors.lastname: Carvalho
authors.forename: Karina Braga
authors.initials: KB
authors.lastname: Gomes
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Fernandes
mesh_terms: D051722:ADAM Proteins / Q000235:genetics / Q000378:metabolism*; D000071120:ADAMTS13 Protein; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D003928:Diabetic Nephropathies / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D018450:Disease Progression; D015870:Gene Expression; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D051379:Mice; D019851:Thrombophilia / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D014841:von Willebrand Factor / Q000235:genetics / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D014841:von Willebrand Factor; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human