Hypercoagulability and Secondary Hyperf ibrinolysis May Be Related to Abnormal Lipid Metabolism in Patients Treated with Continuous Ambulatory Peritoneal Dialysis

Kobayashi, Makoto; Yorioka, Noriaki; Yamakido, Michio

doi:10.1159/000190141

Cited by 35 publications

(37 citation statements)

References 26 publications

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“…On the other hand, PD patients are exposed to greater amounts of glucose in dialysate, leading to a much higher prevalence of insulin resistance, dyslipidemia, and metabolic syndrome (16). There is also evidence that PD patients exhibit greater coagulability, possibly related to dyslipidemia (17). Despite observed differences in known CVD risk factors between PD and HD patients, there has been little study to date of the influence of dialysis modality on CVD risk.…”

mentioning

confidence: 99%

Association of Dialysis Modality and Cardiovascular Mortality in Incident Dialysis Patients

Johnson¹,

Dent²,

Hawley³

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: The aim of the investigation presented here was to compare the rates, causes, and timing of cardiovascular (CV) death in incident peritoneal dialysis (PD) and hemodialysis (HD) patients.Design, setting, participants, & measurements: The study included all adult Australian and New Zealand patients commencing dialysis between January 1, 1997 and December 31, 2007. Rates of and times to CV death were compared by incident rate ratios, cumulative incidence, and multivariable Cox proportional hazards model analyses. Dialysis modality was included in the model as a time-varying covariate, and a competing risks approach was used to obtain cause-specific hazard ratios.Results: Of the 24,587 patients who commenced dialysis (first treatment PD n ‫؍‬ 6521; HD n ‫؍‬ 18,066) during the study, 5669 (21%) died from CV causes [PD 2044 (28%) versus HD 3625 (21%)]. The incidence rates of CV mortality in PD and HD patients were 9.99 and 7.96 per 100 patient-years, respectively (incidence rate ratio PD versus HD, 1.25; 95% confidence interval 1.12 to 1.32). PD was consistently associated with an increased hazard of CV death compared with HD after 1 yr of treatment. This increased risk in PD patients was largely accounted for by an increased risk of death due to myocardial infarction.Conclusions: Dialysis modality is significantly associated with the risk, causes, and timing of CV death experienced by ESRD patients in Australia and New Zealand.

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mentioning

confidence: 99%

Association of Dialysis Modality and Cardiovascular Mortality in Incident Dialysis Patients

Johnson¹,

Dent²,

Hawley³

et al. 2009

Clinical Journal of the American Society of Nephrology

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“…21 PAI-1 levels in HD and CAPD patients are similar to healthy controls, and this supports many earlier studies. 22,23 In contrast, Goedde et al 24 reported high blood levels of PAI-1 during CAPD. Our study showed that TF and PAI-1 mRNA expression and activities in PBMCs were increased in CAPD patients when compared with the healthy subjects.…”

Section: Discussionmentioning

confidence: 96%

Fasudil inhibits tissue factor and plasminogen activator Inhibitor-1 secretion by peripheral blood mononuclear cells in CAPD patients

Chen

Xie

et al. 2016

Renal Failure

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Disturbances in hemostasis are common complications of kidney diseases and correlate well with cardiovascular mortality. Little is known about the effects of fasudil on tissue factor (TF) and plasminogen activator inhibitor-1 (PAI-1) expression in peripheral blood mononuclear cells (PBMCs) in CAPD patients. PBMCs were isolated from 13 individuals with CAPD and 13 healthy subjects. After 4 h of incubation with or without LPS (10 ng/mL), TF and PAI-1 mRNA of PBMCs were detected by RT-PCR. The levels of TF and PAI-1 in culture supernatants of PBMCs were determined by ELISA. Compared with healthy controls, CAPD patients had increased TF, PAI-1 protein and mRNA expression by PBMCs at baseline and after stimulated by LPS (10 ng/mL) [p < 0.001]. The fasudil treatment resulted in a significant effect in decreasing TF and PAI-1 [p < 0.05] synthesis in PBMCs. TF and PAI-1 mRNA expression and activities in PBMCs were increased in CAPD patients. Fasudil reduced LPSmediated TF and PAI-1 expression and activity in PBMCs. These effects may partially be relevant to the clinical benefits of fasudil in the treatment of CAPD patients.

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“…16 Peritoneal dialysis patients also demonstrate significantly higher levels of blood coagulation factors in comparison with healthy controls. Therefore, peritoneal dialysis patients may demonstrate clinical thromboembolic patterns during the early posttransplant period.…”

Section: Discussionmentioning

confidence: 98%

Untitled

2015

Exp Clin Transplant

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Objectives: Solid-organ transplant recipients can develop chronic hypercoagulation that increases the incidence of pulmonary embolism. Here, we evaluate the frequency of pulmonary embolism in solid-organ transplant recipients during the first 10 years after transplantation and evaluate the risk factors for its development. Materials and Methods:The medical records of solid-organ transplant recipients who were treated between 2003 and 2013 were retrospectively reviewed. The reviewed data included demographics, type of transplant, comorbidities, procoagulation factors, thromboembolism prophylaxis, and the timing and extent of pulmonary embolism. Results: In total, 999 solid-organ transplant recipients are included in this study (661 renal and 338 liver transplant recipients) (male: female ratio = 665:334). Twelve renal (1.2%) and 1 liver transplant recipient (0.3%) were diagnosed with pulmonary embolism. Pulmonary embolism developed 1 year after transplantation in 10 patients: 1 patient developed pulmonary embolism < 3 months after transplantation, and the other 9 patients developed pulmonary embolism within 3 to 6 months. No patients had a prior history of deep venous thrombosis or pulmonary embolism. Five patients received tacrolimus, 7 patients received sirolimus, and 1 patient received cyclosporine. Ten patients received prednisolone, and 8 patients received mycophenolate mofetil. All patients were homozygous normal for factor V Leiden and prothrombin genes. One patient was homozygous abnormal, and 1 patient had a heterozygous mutation in the methyl enetetrahydrofolate reductase gene. Two patients were treated with low-molecular-weight heparin, while the remaining patients received warfarin. Eight patients were treated for 6 months, and the remainder received longer treatments. Conclusions: Here, the incidence of pulmonary embolism in solid-organ transplant recipients is 1.2%. Renal transplant recipients are at higher risk of developing pulmonary embolism than liver transplant recipients. The factors that increase the risk of pulmonary embolism in solid-organ transplant recipients appear to be multifactorial and include genetic predisposition.

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Hypercoagulability and Secondary Hyperf ibrinolysis May Be Related to Abnormal Lipid Metabolism in Patients Treated with Continuous Ambulatory Peritoneal Dialysis

Cited by 35 publications

References 26 publications

Association of Dialysis Modality and Cardiovascular Mortality in Incident Dialysis Patients

Association of Dialysis Modality and Cardiovascular Mortality in Incident Dialysis Patients

Fasudil inhibits tissue factor and plasminogen activator Inhibitor-1 secretion by peripheral blood mononuclear cells in CAPD patients

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