Elzorkany Khaled M A, Montaser Belal A M, El-Hefnawy Sally M
Department of Internal Medicine, Nephrology Unit, Faculty of Medicine, Menoufia University, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Menoufia Governorate, Egypt.
Indian J Nephrol. 2018 Jul-Aug;28(4):278-282. doi: 10.4103/ijn.IJN_184_17.
Vascular access complications are major issues in hemodialysis (HD) patients, which increase their morbidity and lessen HD efficiency. The aim of this study was to assess von Willebrand factor (VWF), and a disintegrin and metalloproteinase with eight thrombospondin-type 1 motif (ADAMTS13) levels in HD patients and their association with vascular access thrombosis (VAT). This study included a total of 158 individuals including 128 patients undergoing HD for more than 6 months, subdivided into two groups according to the occurrence of the previous episode of VAT; 60 HD patients with VAT and 68 HD patients without VAT and 30 healthy controls. Plasma ADAMTS13 and VWF levels were assessed by enzyme-linked immunosorbent assay technique. There were higher VWF levels and lower ADAMTS13 in HD patients, compared to healthy controls. Furthermore, VWF levels were significantly higher and ADAMTS13 levels were significantly lower in HD patients with VAT than those without VAT. Further prospective studies with large number of patients are thus needed to show if there is causal relationship between higher VWF levels, lower ADAMTS13, and VAT.
血管通路并发症是血液透析（HD）患者的主要问题，这些并发症会增加患者的发病率并降低血液透析效率。本研究的目的是评估HD患者血管性血友病因子（VWF）和含八个血小板反应蛋白基序的解聚素和金属蛋白酶（ADAMTS13）水平及其与血管通路血栓形成（VAT）的关联。本研究共纳入158例个体，其中包括128例接受血液透析超过6个月的患者，根据既往是否发生过VAT发作分为两组；60例发生VAT的HD患者和68例未发生VAT的HD患者以及30例健康对照。采用酶联免疫吸附测定技术评估血浆ADAMTS13和VWF水平。与健康对照相比，HD患者的VWF水平较高而ADAMTS13水平较低。此外，发生VAT的HD患者的VWF水平显著高于未发生VAT的患者，而ADAMTS13水平显著低于未发生VAT的患者。因此，需要进一步对大量患者进行前瞻性研究，以确定较高的VWF水平、较低的ADAMTS13水平与VAT之间是否存在因果关系。
