Assessment of plasminogen activator inhibitor-1 and von Willebrand factor as a marers of endothelial function in patients with end-stage kidney disease after allotransplantation during a one-year follow-up

Abstract

Objectives. The aim of our study was to determine the endothelial function in patients with chronic kidney disease (CKD), stage V (end-stage renal disease-ESRD), before and during a one-year observation after kidney allotransplantation. Patients and methods. We studied 40 patients with stabile graft function after their first kidney transplantation, including 21 females (mean age 41 ±12.5 yrs) and 19 males (mean age 43.6 ±13.3 yrs), treated already with hemodialysis because of ESRD. Results. After transplantation we observed significant decrease in serum creatinine concentrations (Cr) (7.32 ±2.07 mg/dl to 1.50 ±0.45 mg/dl at 6 months and 1.61 ±0.58 mg/dl after 12 months after transplantation). During 12 months we found changes only in plasminogen activator inhibitor-1 (PAI-1) levels. Von Willebrandt factor (vWF) levels remained unaltered during follow-up and total homocysteine (tHcy) concentration decreased, but this change was not statistically significant. There was no correlation between vWF and PAI-1 concentrations and other clinical and laboratory findings. Conclusions. In our study we did not find any improvement of endothelial function during the first year after kidney allotransplantation. The mean Cr concentration at the end of study was 1.6 mg/dl, which indicates the chronic kidney graft insufficiency. We conclude that despite kidney allotransplantation endothelial function is impaired like in CKD, but with more advanced abnormalities in the cardiovascular system.

Renal transplant and hemostasis: early postoperative changes in recipients and donors

“…Endothelial damage can persist even up to 1-year post transplant. 26 Increased levels of both FVIIIc and vWF have been shown to increase the risks for venous and arterial thrombosis, 27 28 and these data together with results provided here strengthen the argument for initiating pharmacological TP in these patients.…”

“…Further, underlying endothelial damage due to chronic renal disease [ 25 ] and the use of immunosuppressive medications in these patients will result in endothelial cell activation with release of VWF. Endothelial damage can persist even up to 1 year after transplantation [ 26 ]. Increased levels of both FVIIIc and VWF have been shown to increase the risk of venous and arterial thrombosis [ 27 , 28 ], and these data, together with the results provided here, strengthen the argument for initiating pharmacologic TP in these patients.…”

Detection and Validation of Circulating Endothelial Cells, a Blood-based Diagnostic Marker of Acute Myocardial Infarction

“…CEC concentration is a biomarker of endothelial damage, which has been correlated to other markers of endothelial function, including flow-mediated dilation, von Willebrand factor, and tissue plasminogen activator levels [20], [21], [22]. CEC markers are diverse [22], [23], human CECs are defined as Hoechst 33342+/CD45−/CD31+/CD146+/CD133−, whereas mouse CECs are Hoechst 33342+/CD45−/CD31+/KDR+/CD117− in our study.…”