Hemostatic Parameters according to Renal Function and Time after Transplantation in Brazilian Renal Transplanted Patients

Abstract

Kidney transplantation is the key for patients with end-stage renal disease, improving quality of life and longer survival. However, kidney transplant triggers an intense inflammatory response and alters the hemostatic system, but the pathophysiological mechanisms of these changes are not completely understood. The aim of this cross-sectional cohort study was to investigate hemostatic biomarkers in Brazilian renal transplanted patients according to renal function and time after transplantation. A total of 159 renal transplanted patients were enrolled and D-Dimer (D-Di), Thrombomodulin (TM), von Willebrand Factor (VWF), and ADAMTS13 plasma levels were assessed by ELISA. An increase of D-Di was observed in patients with higher levels of creatinine. ADAMTS13 levels were associated with creatinine plasma levels and D-Di levels with Glomerular Filtration Rate. These results suggested that D-Di and ADAMTS13 can be promising markers to estimate renal function. ADAMTS13 should be investigated throughout the posttransplant time to clarify the participation of this enzyme in glomerular filtration and acceptance or rejection of the graft in Brazilian transplanted patients.

Cell‐derived microparticles and von Willebrand factor in Brazilian renal transplant recipients

“…Of note, this is the first descriptive cross‐sectional study that investigates the relationship between MPs and VWF in Brazilian RTx. The studied population was distributed into groups according to creatinine plasma levels and eGFR, both markers used frequently to estimate the renal function on clinical practice and according to time post‐transplant …”

“…All patients were evaluated according to renal allograft function measured by creatinine plasma levels (C1: creatinine <1.4 mg/dL ( n = 49) and C2: creatinine ≥1.4 mg/dL ( n = 42)) and estimated glomerular filtration rate (eGFR) (R1 > 60 mL/min per 1.73 m 2 ( n = 41) and R2: ≤60 mL/min per 1.73 m 2 ( n = 50)). The cut off of creatinine plasma levels and eGFR were based in the literature and previous clinical experiences of our group . Additionally, the time post‐transplant (T1: 3–24 months ( n = 13); T2: 25–60 months ( n = 26); T3: 61–120 months ( n = 30); and T4: > 120 months ( n = 22)) was used to assess the patients …”

“…Stable renal function was defined as absence for 3 months or more of allograft rejection signals, such as: dialysis indications after the first week post‐transplant; burning sensation and\or pain during urination; decreased urine volume (oliguria of less than 0.5 mL/kg per h for more than 6 h); bloody or fetid urine; pain or swelling at the surgical site or other location (e.g. eyelids, hands or feet); fever; cough and diarrhea; shortness of breath; excessive weight gain in a short time; an absolute increase in creatinine levels of ≥0.3 mg/dL (≥26.4 μmol/L) baseline values and increased blood pressure …”

“…The IMUBIND® VWF ELISA kit (Sekisui Diagnostics; Burlington, MA, USA) was used, following strictly the manufacturer's instructions. The VWF reference range was 683–1012 mU/mL, previously determined by our research group in another study …”

Regulatory and pro‐inflammatory cytokines in Brazilian living‐related renal transplant recipients according to creatinine plasma levels

“…Patients were categorized according to creatinine plasma levels in three different groups, C1: creatinine less than 1.4 mg/dL ( n = 55), C2: creatinine within 1.4–2.0 mg/dL ( n = 45) and C3: creatinine more than 2.0 mg/dL ( n = 20). Creatinine plasma levels were based in the literature and in our previous clinical experiences . Table summarizes the clinical and demographic characteristics of the population in this study according to creatinine plasma levels.…”