Plasminogen activator inhibitor-1 activity and 4G/5G polymorphism in hemodialysis

Details

Serval ID
serval:BIB_CB8560B99DA1
Type
Article: article from journal or magazin.
Collection
Publications
Title
Plasminogen activator inhibitor-1 activity and 4G/5G polymorphism in hemodialysis
Journal
Journal of Vascular Access
Author(s)
Trimarchi H., Duboscq C., Genoud V., Lombi F., Muryan A., Young P., Schwab M., Castanon M., Rodriguez-Reimundes E., Forrester M., Pereyra H., Campolo-Girard V., Seminario O., Alonso M., Kordich L.
ISSN
1129-7298
Publication state
Published
Issued date
2008
Volume
9
Number
2
Pages
142-147
Language
english
Abstract
Introduction: Chronic insufficiency alters homeostasis, in part due to endothelial inflammation. Plasminogen activator inhibitor-1 (PAI-1) is increased in renal disease, contributing to vascular damage. We assessed PAI-1 activity and PAI-1 4G/5G polymorphism in hemodialysis (HD) subjects and any association between thrombotic vascular access (VA) events and PAI-1 polymorphism.
Methods: Prospective, observational study in 36 HD patients: mean age: 66.6 +/- 12.5 yr, males n=26 (72%), time on HD: 28.71 +/- 22.45 months. Vascular accesses: 10 polytetrafluoroethylene grafts (PTFEG), 22 arteriovenous fistulae (AVF), four dual lumen catheters (CAT). Control group (CG): 40 subjects; mean age: 60.0 +/- 15 yrs, males n=30 (75%). Group A (GA): thrombotic events (n=12), and group B (GB): No events (n=24). Groups were no different according to age (69.2 +/- 9.12 vs. 65.3 +/- 14.5 yrs), gender (males: 7; 58.3% vs. 18; 81.8%), time on HD (26.1 +/- 14.7 vs. 30.1 +/- 38.7 months), causes of renal failure. Time to follow-up, for access thrombosis: 12 months.
Results: PAI-1 levels in HD: 7.21 +/- 2.13 vs. CG: 0.42 +/- 0.27 U/ml (p < 0.000 1). PAI-1 4G/5G polymorphic variant distribution in HD: 5G/5G: 6 (17%),4G/5G: 23 (64%); 4G/4G: 7 (19%) and in CG: 5G/5G: 14 (35%); 4G/5G: 18 (45%); 4G/4G: 8 (20%). C-reactive protein (CRP) in HD: 24.5 +/- 15.2 mg/L vs. in CG 2.3 +/- 0.2 mg/L (p < 0.0001). PAI-1 4G/5G variants: GA: 5G/5G: 3; 4G/5G: 8; 4G/4G: 1; GB: 5G/5G: 3; 4G/5G: 15; 4G/4G: 6. Thrombosis occurred in 8/10 patients (80%) with PTFEG, 3/22 (9%) in AVF, and 1/4 (25%) in CAT. Among the eight PTFEG patients with thrombosis, seven were PAI 4G/5G.
Conclusions: PAI-1 levels were elevated in HD patients, independent of their polymorphic variants, 4G/5G being the most prevalent variant. Our data suggest that in patients with PTFEG the 4G/5G variant might be associated with an increased thrombosis risk.
Keywords
plasminogen activator inhibitor-1, hemodialysis, endothelium, C-reactive protein, thrombosis, 4G/5G polymorphism, aortic endothelial-cells, c-reactive protein, growth-factor-beta, messenger-rna, pai-1 levels, ace-i/d, expression, type-1, tissue, lipopolysaccharide
Web of science
Create date
14/10/2009 12:13
Last modification date
20/08/2019 15:46
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