ackground : Recently we decribed that in the physiologic state, urokinase concentration is
higher in the renal vein than in the renal artery which is suggests that kidney is the
essential organ providing urokinases to the systemic circulation. In ESRD patients, urokinase
provided by the kidney may be decreased and this might be the cause of decreased systemic
fibrinolytic activity seen in ESRD.
Method : To study this possibility, we measured fibrinolytic profiles including urokinase,
t-PA and fibrinolytic activity in euglobulin fraction from ESRD patients and compared the
results with the of two control groups consisting of renal transplant patients, and age and
sex matched healthy control group.
Results : The euglobulin fibrinolytic activity was 92.2±14.8 BAU in the healthy control
group. Although It was lower in the ESRD group than in KT group (p<0.005) and the
healthy control group (p<0.005), there was no difference between the KT group and the
healthy control group. T-PA ag was 1.2±1.3 ng/ml in the ESRD group, 3.5±1.7 ng/ml in the
KT group (p<0.001) and the healthy control group (p<0.001) but there was no difference
between the KT group and the healthy control group. Urokinase ag was 0.6±0.2 ng/ml in
the ESRD group, 2.0±1.5 ng/ml in the KT group and 2.6±0.3 ng/ml in the healthy control
group. It was lower in the ESRD group compared to the KT group (p<0.001) and the
healthy control group (p<0.001) but there was no difference between KT group and healthy
control group.
Conclustion : The total fibrinolytic activity in euglobulin, t-TA and urokinase were lower
in ESRD than the control group and it became normalized after successful renal
transplantation. These results might offer some information on the relatively frequent
thrombosis related complications, in spite of bleeding tendency, seen in ESRD.
|