Arteriovenous Fistula Obstruction and Expression of Platelet Receptors for Von Willebrand Factor and for Fibrinogen (Glycoproteins GPIb and GPIIb/llla) in Hemodialysis Patients

Abstract

Platelet surface receptors for von Willebrand factor and for fibrinogen (glycoproteins GPIb and GPIIb/IIIa) were studied with monoclonal antibodies CD42 and CD41 and cytofluorometry in 31 healthy subjects, 10 hemodialysis patients with no A-V fistula obstruction (patent original fistula), 10 hemodialysis patients with frequent A-V fistula obstruction (more than twice), 12 patients with mild chronic renal failure (creatinine 1.75 +/- 0.40 mg/100 ml), 11 patients with advanced chronic renal failure (creatinine 5.62 +/- 1.22 mg/100 ml), and 10 patients with end-stage renal disease (ESRD) treated with peritoneal dialysis. There was a significant increase of platelet surface glycoproteins GPIb and GPIIb/IIIa in the population of hemodialysis patients with frequent A-V fistula obstruction. The expression of these platelet receptors might be related to the prothrombotic tendency of a group of patients with ESRD, who suffer more occlusive and thrombotic events of the A-V fistula. This group of patients may also have a higher frequency of systemic thrombotic and atherosclerotic complications.

Cellulose Triacetate Dialyzer Reduces Platelet Loss during Continuous Veno-Venous Hemofiltration

“…GPIIb/IIIa is the receptor for fibrinogen that has been identified as the pivotal mediator of platelet aggregation [26] . PAC1 is an activated but unoccupied GPIIb/IIIa complex that is one of the markers of platelet activation [6] .…”

Coagulation dynamics and platelet functions in obstructive jaundiced patients

“…This antigen is a part of the platelet adhesion receptor gpIb/V/IX which binds subendothelial von Willebrand factor and it is internalized after platelet activation 13 . The expression of this receptor was enhanced in uremic patients with an increased risk of occlusion of arteriovenous fistulae 23 . In addition, ligand‐induced binding sites (LIBS‐1) epitopes were detected far more frequently on platelets from patients with primary biliary cirhhosis and primary sclerozing cholangitis? 13 These neoepitopes are unraveled by conformational changes in the integrin receptors gp IIb/IIIa by physiological stimuli.…”

Prothrombotic risk factors in patients with recurrent thrombosis of the arteriovenous fistula

“…Liani et al 7 studied platelet surface receptors for von Willebrand factor and fibrinogen (glycoproteins, GPIb, and GPIIb/IIIa) with monoclonal antibodies of CD41 and CD42. They detected a significant increase in platelet surface glycoproteins (GPIb and GPIIb/IIIa) in hemodialysis patients with frequent AV fistula…”

“…7 Knoll et al 8 recently studied the role of thrombophilia in hemodialysis patients in order to determine whether thrombophilia was associated with AV fistula or graft thrombosis. They reported that 59 patients with access thrombosis (55%) had at least 1 thrombophilia compared with 122 patients without access thrombosis (39%).…”

“…5 Although some studies have reported the frequency of AV fistula thrombosis, little is known about the prothrombotic risk factors that predispose patients with chronic renal failure to recurrent thrombosis. [6][7][8] In this study, we investigated the role of prothrombotic risk factors in the development of recurrent thrombosis of the AV fistula.…”