Upregulation of surrogate markers of inflammation and thrombogenesis in patients with ESRD: pathophysiologic and therapeutic implications

Clin Appl Thromb Hemost. 2011 Jun;17(3):302-4. doi: 10.1177/1076029610387127. Epub 2010 Dec 15.

Abstract

Patients with end-stage renal disease (ESRD) undergoing regular hemodialysis have high annual mortality rate of around 15%. The most predominant cause of death is cardiovascular, which is not entirely explainable with conventional cardiac risk factors present in these patients. It has been postulated that ESRD is a chronic inflammatory and hypercoagulable condition with marked elevation of several markers that may explain this high mortality. In the current study, patients with ESRD on a stable regimen of hemodialysis were studied for the inflammatory and thrombogenesis markers to explain this phenomenon. The parameters studied were of thrombogenesis-thrombin-antithrombin III complex (TAT), prothrombin fragment (F1.2), D-dimer, and fibrinopeptide A (FPA) and inflammation-CD40 ligand, myeloperoxidase (MPO), tumor necrosis factor α (TNF-α), monocyte chemotactic protein-1 (MCP-1), and nitric oxide (NO), and compared to control group comprised of 100 healthy volunteers. Our study shows that ESRD patients exhibit activation of the coagulation and inflammatory processes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Blood Coagulation
  • Blood Proteins / analysis*
  • Female
  • Humans
  • Inflammation / blood
  • Inflammation / mortality
  • Inflammation Mediators / blood*
  • Kidney Failure, Chronic / blood*
  • Kidney Failure, Chronic / mortality
  • Male
  • Middle Aged
  • Thrombosis / blood*
  • Thrombosis / mortality
  • Up-Regulation

Substances

  • Biomarkers
  • Blood Proteins
  • Inflammation Mediators