Sp657the Role of Von Willebrand Factor in Hemodialysis Patients. Does Acquired Von Willenbrand Syndrome Occur?

Marchini, M; Franzini, Maria; Baglini, Deborah; Caponi, Laura; Giglio, Elisabetta; Egidi, Maria Francesca

doi:10.1093/ndt/gfy104.sp657

Cited by 2 publications

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“…Decreased ULvWF ratio was observed in the gel electrophoresis of vWF (23). Marchini et al also recently reported similar findings as that of Gralnick et al (24). The results of the baseline vWF characteristics in this study are consistent with those of previous studies.…”

Section: Discussionsupporting

confidence: 91%

Effect of far-infrared radiation therapy on von Willebrand factor in patients with chronic kidney disease

Yen,

Hsu,

Lin

et al. 2023

Front. Med.

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BackgroundHemostatic abnormality has contributed to vascular access thrombosis in patients with chronic kidney disease (CKD). Previous studies have demonstrated that far-infrared radiation (FIR) therapy can maintain the patency and maturity of arteriovenous fistulas of patients undergoing hemodialysis (HD). However, prolonged access bleeding is observed once FIR is conducted at the end of dialysis. FIR can block the binding of platelet and von Willebrand factor (vWF), a predictor of hemostatic abnormality and vascular access thrombosis. However, clinical studies exploring FIR and vWF are sparse.MethodsWe recruited 20 HD patients, 21 CKD patients, and 20 controls to examine the alteration of vWF and a disintegrin and metalloproteinase with thrombospondin type 1 repeats 13 (ADAMTS13) following a single 40-min session of FIR therapy. In addition, the alteration of these factors in the HD group was examined following a 40-min FIR session thrice a week for 3 months.ResultsA decreasing trend in the vWF activity-antigen ratio of participants in all groups following a single FIR session was observed. In addition, the ratio in the HD group was significantly lower following 3 months of FIR therapy. The subgroup analysis revealed a consistent trend and multiple regression analysis showed that participants not taking hydroxymethylglutaryl-coenzyme A reductase inhibitor, diabetes mellitus, and higher hemoglobin levels were the significant factors. The alteration of the vWF activity-antigen ratio correlated moderately to that of ADAMTS13 antigen and activity.ConclusionFIR may alter the ratio of ultra-large vWF multimers through ADAMTS13, contributing to inhibiting platelet-endothelium interactions of CKD patients.

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Section: Discussionsupporting

confidence: 91%

Effect of far-infrared radiation therapy on von Willebrand factor in patients with chronic kidney disease

Yen,

Hsu,

Lin

et al. 2023

Front. Med.

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“…These therapies are based on common drugs that do not sufficiently block shear-induced activation pathway in platelets [ 20 , 83 , 84 ]. Moreover, a shift in the VWF distribution to smaller multimers has been observed in haemodialysis patients [ 85 ]. We suppose that the use of drugs capable of effectively blocking SIPAct should reduce the level of thrombotic complications in haemodialysis patients [ 86 , 87 ].…”

Section: Discussionmentioning

confidence: 99%

Patient specific approach to analysis of shear-induced platelet activation in haemodialysis arteriovenous fistula

et al. 2022

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Shear-induced platelet activation (SIPAct) is an important mechanism of thrombosis initiation under high blood flow. This mechanism relies on the interaction of platelets with the von Willebrand factor (VWF) capable of unfolding under high shear stress. High shear stress occurs in the arteriovenous fistula (AVF) commonly used for haemodialysis. A novel patient-specific approach for the modelling of SIPAct in the AVF was proposed. This enabled us to estimate the SIPAct level via computational fluid dynamics. The suggested approach was applied for the SIPAct analysis in AVF geometries reconstructed from medical images. The approach facilitates the determination of the SIPAct level dependence on both biomechanical (AVF flow rate) and biochemical factors (VWF multimer size). It was found that the dependence of the SIPAct level on the AVF flow rate can be approximated by a power law. The critical flow rate was a decreasing function of the VWF multimer size. Moreover, the critical AVF flow rate highly depended on patient-specific factors, e.g., the vessel geometry. This indicates that the approach may be adopted to elucidate patient-specific thrombosis risk factors in haemodialysis patients.

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Sp657the Role of Von Willebrand Factor in Hemodialysis Patients. Does Acquired Von Willenbrand Syndrome Occur?

Cited by 2 publications

References 0 publications

Effect of far-infrared radiation therapy on von Willebrand factor in patients with chronic kidney disease

Effect of far-infrared radiation therapy on von Willebrand factor in patients with chronic kidney disease

Patient specific approach to analysis of shear-induced platelet activation in haemodialysis arteriovenous fistula

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