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Article: Physiologic Inhibitors of Coagulation in Patients on Chronic Hemodialysis

TitlePhysiologic Inhibitors of Coagulation in Patients on Chronic Hemodialysis
Authors
KeywordsHemodialysis
Thrombosis
Protein S
Protein C
Antithrombin III
Issue Date2003
PublisherBlackwell Publishing, Inc. The Journal's web site is located at http://www.blackwellpublishing.com/journals/HDI
Citation
Hemodialysis International, 2003, v. 7 n. 3, p. 232-238 How to Cite?
AbstractPatients on hemodialysis are at increased risk for bleeding and thromboses. The intriguing balance between these risks is more complex than once thought, as endogenous clotting factors and their regulators come into contact with bioincompatible dialyzer membranes, in the setting of an extracorporeal circuit of blood flow, in the face of the uremic state. In this review, we summarize the current data on the interaction between the physiologic inhibitors of coagulation and hemodialysis. Data sources and study selection were obtained from research and review articles related to the endogenous anticoagulation pathway published in English on MEDLINE from 1972 to 2002. While protein C activity and protein S antigen concentrations are increased, there is no change in antithrombin III levels during hemodialysis in relation to predialysis levels. Plasma protein Z, which has only recently been studied in uremic subjects, is increased as well. In addition, hemodialysis leads to elevated tissue factor plasminogen inhibitor, thrombomodulin, tissue plasminogen activator, and plasminogen activator inhibitor-1 activities. The potential functional significance of these observations is discussed. Finally, as erythropoietin is commonly prescribed to uremic patients and is recognized to be prothrombotic, an appraisal of its interaction with the naturally occurring anticoagulants is presented. It is apparent that we are only beginning to realize the complexity of the interplay between this myriad of serum factors and hemodialysis. Further research is needed to shed light on this underexplored area of hemodialysis.
Persistent Identifierhttp://hdl.handle.net/10722/78617
ISSN
2015 Impact Factor: 1.495
2015 SCImago Journal Rankings: 0.568

 

DC FieldValueLanguage
dc.contributor.authorTang, SCWen_HK
dc.contributor.authorLai, KNen_HK
dc.date.accessioned2010-09-06T07:44:52Z-
dc.date.available2010-09-06T07:44:52Z-
dc.date.issued2003en_HK
dc.identifier.citationHemodialysis International, 2003, v. 7 n. 3, p. 232-238en_HK
dc.identifier.issn1492-7535en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78617-
dc.description.abstractPatients on hemodialysis are at increased risk for bleeding and thromboses. The intriguing balance between these risks is more complex than once thought, as endogenous clotting factors and their regulators come into contact with bioincompatible dialyzer membranes, in the setting of an extracorporeal circuit of blood flow, in the face of the uremic state. In this review, we summarize the current data on the interaction between the physiologic inhibitors of coagulation and hemodialysis. Data sources and study selection were obtained from research and review articles related to the endogenous anticoagulation pathway published in English on MEDLINE from 1972 to 2002. While protein C activity and protein S antigen concentrations are increased, there is no change in antithrombin III levels during hemodialysis in relation to predialysis levels. Plasma protein Z, which has only recently been studied in uremic subjects, is increased as well. In addition, hemodialysis leads to elevated tissue factor plasminogen inhibitor, thrombomodulin, tissue plasminogen activator, and plasminogen activator inhibitor-1 activities. The potential functional significance of these observations is discussed. Finally, as erythropoietin is commonly prescribed to uremic patients and is recognized to be prothrombotic, an appraisal of its interaction with the naturally occurring anticoagulants is presented. It is apparent that we are only beginning to realize the complexity of the interplay between this myriad of serum factors and hemodialysis. Further research is needed to shed light on this underexplored area of hemodialysis.-
dc.languageengen_HK
dc.publisherBlackwell Publishing, Inc. The Journal's web site is located at http://www.blackwellpublishing.com/journals/HDIen_HK
dc.relation.ispartofHemodialysis Internationalen_HK
dc.rightsThe definitive version is available at www.blackwell-synergy.com-
dc.subjectHemodialysis-
dc.subjectThrombosis-
dc.subjectProtein S-
dc.subjectProtein C-
dc.subjectAntithrombin III-
dc.titlePhysiologic Inhibitors of Coagulation in Patients on Chronic Hemodialysisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1492-7535&volume=7&spage=232&epage=238&date=2003&atitle=Physiologic+Inhibitors+of+Coagulation+in+Patients+on+Chronic+Hemodialysisen_HK
dc.identifier.emailTang, SCW: scwtang@hkucc.hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityTang, SCW=rp00480en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.identifier.doi10.1046/j.1492-7535.2003.00043.x-
dc.identifier.pmid19379370-
dc.identifier.hkuros87960en_HK
dc.identifier.volume7-
dc.identifier.issue3-
dc.identifier.spage232-
dc.identifier.epage238-
dc.publisher.placeUnited States-

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