Coagulation factor XIII in patients with acute and chronic renal disease.

The behavior of coagulation factor XIII (fibrin-stabilizing factor, FSF) was studied in patients with renal disease. Specific antiserum against the active subunit (FSFA) was employed to set up a method for the direct measurement of the active fraction in plasma, according to the electroimmunodiffusion technique. The plasma FSFA levels were measured in the following patients: (I) 31 patients with chronic renal disease and serum creatinine not higher than 1.5 mg/dl; (II) 41 patients with chronic renal failure on conservative therapy; (III) 53 uremic patients on maintenance hemodialysis; (IV) 10 patients with acute renal failure. FSFA concentration (93.3 +/- 17.6% of a reference plasma in a group of 15 healthy controls) was found to be significantly higher than normal in the patients with chronic renal disease and serum creatinine lower than 1.5 mg/dl (127 +/- 39.8%, p less than 0.005). The FSFA levels were similarly increased in the 41 patients with chronic renal failure on conservative management (134.9 +/- 35.8%, p less than 0.001), and in the 53 end-stage uremics on maintenance hemodialysis (132.8 +/- 29.5%, p less than 0.001). Whereas, FSFA concentration was found to be markedly reduced in the 10 patients with acute renal failure (35.8 +/- 14.6%, p less than 0.001). In the patients with chronic renal disease (groups I, II, and III) plasmatic FSFA higher in those patients with serum triglycerides above the upper normal limit, and a significant positive correlation was found between serum triglycerides and FSFA plasma levels.