title: Effects of ultrapure hemodialysis and low molecular weight heparin on the endothelial surface layer.
abstract: BACKGROUND
  Chronic kidney disease patients show changes in the endothelial surface layer (ESL). Whether hemodialysis (HD) itself or low molecular weight heparins (LMWH) induce ESL alterations is unknown.
  
  
  METHODS
  We studied the ESL in 20 HD patients with Sidestream Dark Field Imaging [measuring perfused boundary region (PBR)] and measurement of ESL constituents in plasma during HD in 2 studies. LMWH was administered at the start of HD in study A, and 120 min after the start of HD in study B. Mean platelet volume (MPV) and platelet large cell ratio (P-LCR) were also measured.
  
  
  RESULTS
  Syndecan-1 increased significantly 30 min after LMWH administration. sP-Selectin increased 120 min after HD start, and MPV and P-LCR decreased significantly during HD. No significant changes of PBR, sE-Selectin, sICAM-1, or sVCAM-1 were perceived.
  
  
  CONCLUSIONS
  HD caused a significant increase in Syndecan-1 without a change in PBR. The administration of LMWH appeared to precede the rise in Syndecan-1.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Cornelis
authors.forename: Natascha J H
authors.initials: NJ
authors.lastname: Broers
authors.forename: Denise C L M
authors.initials: DC
authors.lastname: Titulaer
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Henskens
authors.forename: Rene
authors.initials: R
authors.lastname: van Oerle
authors.forename: Frank M
authors.initials: FM
authors.lastname: van der Sande
authors.forename: Henri M
authors.initials: HM
authors.lastname: Spronk
authors.forename: Hans
authors.initials: H
authors.lastname: Vink
authors.forename: Karel M
authors.initials: KM
authors.lastname: Leunissen
authors.forename: Hugo
authors.initials: H
authors.lastname: ten Cate
authors.forename: Jeroen P
authors.initials: JP
authors.lastname: Kooman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D015314:Dialysis Solutions / Q000737:chemistry; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects / Q000293:injuries / Q000648:ultrastructure*; D005260:Female; D019276:Glycocalyx / Q000187:drug effects / Q000648:ultrastructure; D006452:Hemoglobinometry / Q000295:instrumentation / Q000379:methods; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D063847:Mean Platelet Volume; D008833:Microcirculation; D008853:Microscopy / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D009060:Mouth Floor / Q000098:blood supply; D017762:Nadroparin / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D019007:P-Selectin / Q000097:blood; D019095:Point-of-Care Systems; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000473:pathology* / Q000628:therapy; D012494:Sampling Studies; D053668:Syndecan-1 / Q000097:blood*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: D000925:Anticoagulants; D015314:Dialysis Solutions; D019040:E-Selectin; D017762:Nadroparin; D019007:P-Selectin; C508241:SDC1 protein, human; C546936:SELE protein, human; D053668:Syndecan-1; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1