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Titolo:
Soluble thrombomodulin is associated with viral hepatitis, blood pressure,and medications in haemodialysis patients
Autore:
Borawski, J; Naumnik, B; Pawlak, K; Mysliwiec, M;
Indirizzi:
Med Acad Bialystok, Dept Nephrol & Internal Med, PL-15540 Bialystok, Poland Med Acad Bialystok Bialystok Poland PL-15540 PL-15540 Bialystok, Poland
Titolo Testata:
NEPHROLOGY DIALYSIS TRANSPLANTATION
fascicolo: 4, volume: 16, anno: 2001,
pagine: 787 - 792
SICI:
0931-0509(200104)16:4<787:STIAWV>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLASMA THROMBOMODULIN; HEMODIALYSIS-PATIENTS; CARDIOVASCULAR RISK; INFLAMMATION; EXPRESSION; MARKERS; FAILURE; DISEASE; SERUM;
Keywords:
arterial blood pressure; erythropoietin; haemodialysis; heparin; soluble thrombomodulin viral hepatitis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Borawski, J Med Acad Bialystok, Dept Nephrol & Internal Med, 14 Zurawia St, PL-15540 Bialystok, Poland Med Acad Bialystok 14 Zurawia St Bialystok Poland PL-15540 nd
Citazione:
J. Borawski et al., "Soluble thrombomodulin is associated with viral hepatitis, blood pressure,and medications in haemodialysis patients", NEPH DIAL T, 16(4), 2001, pp. 787-792

Abstract

Background. The level of soluble thrombomodulin (sTM), a traditional marker of endothelial injury, is also dependent on renal excretory function. We studied serum sTM in chronic haemodialysis (HD) patients to determine whichfactors are predictive of its levels in this population. Methods and results. sTM levels of 10.7 (5.72-30.7) ng/ml in 100 HD patients were higher than in 30 controls (P < 0.0001). In a bivariate regression analysis, immunoreactive sTM was positively associated with the presence ofhepatitis B virus surface antigen and/or anti-hepatitis C virus antibodiesmeasured by third generation ELISAs (P < 0.0001), and was related to certain markers of liver injury and biosynthetic dysfunction. sTM was also directly associated with time on dialysis (P = 0.001), or use of unfractionated heparin (UFH) (vs enoxaparin) (P = 0.0007), erythropoietin (P = 0.008), ACE-inhibitors (P = 0.034), acetate-buffered dialysate (vs bicarbonate) (P = 0.040), pre-dialysis systolic (P = 0.012), and diastolic blood pressure (P =0.043). It was negatively associated with lipoprotein(a) (P = 0.029). sTM was not related to age, sex, smoking, cause of renal failure, prevalence ofcardiovascular disease, amount of HD delivered, preserved residual renal function, ferritin, C-reactive protein, and other vasoactive medications used. In a multivariable analysis, a positive hepatitis marker (P = 0.0002), the use of UFH (P = 0.030) and erythropoietin (P = 0.019), and raised pre-dialysis blood pressure (P = 0.034) were positive independent predictors of high sTM level. Conclusion. Those data indicate that, in addition to endothelial activation, elevated sTM levels in HD patients may be related to viral infection and/or liver dysfunction, and influenced by modifiable factors such as increased blood pressure, and the type of heparin and erythropoietin treatment used.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 03:41:30