Małyszko J S, Małyszko J, Skrzydlewska E, Pawlak K, Myśliwiec M
Department of Nephrology and Transplantology, Medical University of Białystok, Poland.
Rocz Akad Med Bialymst. 2004;49:197-200.
Disturbances in hemostasis are common complications of kidney diseases. Both bleeding diathesis and thromboembolism may complicate the course of chronic uremia. As far as we know, there is a limited data about protein Z in kidney disease.
The aim of our work was to examine plasma protein Z and vitamin K concentrations in nephrotic syndrome (n = 34), glomerulonephritis (n = 48), kidney transplant recipients (n = 80), peritoneally dialyzed patients (n = 42) and in the healthy volunteers (n = 27).
Vitamin K was significantly lower in nephrotic syndrome when compared to non-nephrotic patients, CAPD and healthy volunteers (p < 0.05). Protein Z was the highest in CAPD and kidney transplant recipients when compared to any other group. In nephrotic syndrome protein Z was significantly lower when compared to the healthy volunteers, but it did not differ significantly between two groups of patients with chronic renal failure (with and without nephrotic syndrome). Protein Z correlated only with fibrinogen in CAPD, glomerulonephritis and nephrotic patients. Vitamin K correlated with age and albumin in patients with glomerulonephritis, nephrotic syndrome as well as with albumin in CAPD.
Alterations in protein Z might contribute to the enhanced risk of thromboembolic complications in nephrotic syndrome, CAPD and Tx via different and unknown mechanisms. This phenomenon seems to be unrelated to vitamin K status in these patients.
止血功能紊乱是肾脏疾病常见的并发症。出血素质和血栓栓塞均可使慢性尿毒症病情复杂化。据我们所知,关于肾脏疾病中蛋白Z的数据有限。
我们研究的目的是检测肾病综合征(n = 34)、肾小球肾炎(n = 48)、肾移植受者(n = 80)、腹膜透析患者(n = 42)及健康志愿者(n = 27)的血浆蛋白Z和维生素K浓度。
与非肾病患者、持续性非卧床腹膜透析(CAPD)患者及健康志愿者相比,肾病综合征患者的维生素K显著降低(p < 0.05)。与其他任何组相比,CAPD患者和肾移植受者的蛋白Z最高。与健康志愿者相比,肾病综合征患者的蛋白Z显著降低,但两组慢性肾衰竭患者(有和无肾病综合征)之间无显著差异。在CAPD患者、肾小球肾炎患者和肾病患者中,蛋白Z仅与纤维蛋白原相关。在肾小球肾炎患者、肾病综合征患者中,维生素K与年龄和白蛋白相关,在CAPD患者中,维生素K与白蛋白相关。
蛋白Z的改变可能通过不同的未知机制导致肾病综合征、CAPD和肾移植患者血栓栓塞并发症风险增加。这种现象似乎与这些患者的维生素K状态无关。