Morphological and functional differences in haemostatic axis between kidney transplanted and end-stage renal disease patients.

Détails

ID Serval
serval:BIB_CCFAC0374AD3
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Morphological and functional differences in haemostatic axis between kidney transplanted and end-stage renal disease patients.
Périodique
Transplant International : Official Journal of the European Society For Organ Transplantation
Auteur(s)
Fiorina P., Folli F., Ferrero E., Orsenigo E., Finzi G., Mazzolari G., Placidi C., Perego L., La Rosa S., Melandri M., Monti L., Capella C., D'Angelo A., Staudacher C., Secchi A.
ISSN
0934-0874 (Print)
ISSN-L
0934-0874
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
18
Numéro
9
Pages
1036-1047
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish
Résumé
End-stage renal disease (ESRD) is characterized by several atherothrombotic abnormalities, and kidney transplant seems to improve most of them. However, because it is not clear which mechanism is responsible for such improvement, our purpose was to clarify that point.We conducted a cross sectional study involving 30 ESRD patients, 30 ESRD kidney-transplanted patients (Ktx) and 30 healthy controls (C) to evaluate platelet morphology and function, atherothrombotic profile, endothelial abnormalities and cytokine levels involved in the insulin resistance/endothelial dysfunction. (i) Platelet morphology: The ESRD group showed platelet size similar to the other two groups (ESRD=3518x10(3)+/-549x10(3) nm2, C=3075x10(3)+/-197x10(3) nm2, Ktx=2862x10(3)+/-205x10(3) nm2) with similar platelet granules and number. (ii) Platelet surface glycoprotein: The CD41 and P-Selectin were similar between groups. (iii) Platelet intracellular calcium: Resting intracellular calcium was statistically higher in ESRD compared to the C group (ESRD=182.1+/-34.5, Ktx=126.7+/-14.1, C=72.0+/-11.0 nM, P<0.01). (iv) Hypercoagulability markers and natural anticoagulants: The Ktx and ESRD groups showed higher levels of hypercoagulability markers compared to the C group. A reduction in antithrombin activity was evident in ESRD compared to the Ktx group (P=0.03). (v) Endothelial morphology: The ESRD group showed a thickened vessel basal membrane compared to the Ktx and C groups with more endothelial sufference. (vi) Insulin resistance and pro-inflammatory cytokine profile: The ESRD showed a higher homeostasis model assessment provided equations for estimating insulin resistance (HOMA-IR) compared to the Ktx and C groups (ESRD=2.6+/-0.3, Ktx=1.8+/-0.2, C=1.1+/-0.1, P=0.005) and increased soluble tumor neurosis factor alpha (sTNFalpha) (P<0.05) and soluble vascular cell adhesion molecule (sVCAM) levels (P<0.01). Positive correlations were evident among HOMA-IR and sTNFalpha (P<0.001) and sVCAM (P=0.01), respectively. In a small subgroup of ESRD who underwent Ktx (five pts), our findings were confirmed at 1 year of follow-up, suggesting an improvement of almost haemostatic abnormalities. Kidney transplant is associated with a better atherothrombotic profile in ESRD, platelet intracellular calcium and cytokines seem to be most influenced by the transplant, while most morphological abnormalities are retained.
Mots-clé
Adult, Blood Platelets/pathology, Blood Platelets/ultrastructure, Calcium/blood, Cross-Sectional Studies, Endothelium, Vascular/pathology, Hemostasis, Humans, Insulin Resistance, Interleukin-18/blood, Kidney Failure, Chronic/blood, Kidney Failure, Chronic/pathology, Kidney Transplantation
Pubmed
Web of science
Open Access
Oui
Création de la notice
06/09/2016 14:49
Dernière modification de la notice
20/08/2019 15:47
Données d'usage