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Thromb Haemost 1984; 52(03): 311-314
DOI: 10.1055/s-0038-1661203
Original Article
Schattauer GmbH Stuttgart

Fibrinolytic Activators and Inhibitors in Terminal Renal Insufficiency and in Anephric Patients

E J P Brommer
The Gaubius Institute, Health Research Division TNO, Leiden, The Netherlands
,
I Schicht
*   The Dept. of Nephrology, Academic Hospital, Leiden, The Netherlands
,
G Wijngaards
The Gaubius Institute, Health Research Division TNO, Leiden, The Netherlands
,
J H Verheijen
The Gaubius Institute, Health Research Division TNO, Leiden, The Netherlands
,
D C Rijken
The Gaubius Institute, Health Research Division TNO, Leiden, The Netherlands
› Author Affiliations
Further Information

Publication History

Received 03 August 1984

Accepted 24 September 1984

Publication Date:
19 July 2018 (online)

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Summary

Fibrinolytic factors were measured before and after DDAVP- infusion in 18 patients on chronic, regular haemodialysis, 11 of whom underwent bilateral nephrectomy, and in 7 patients in whom non-functioning kidneys were still present. Baseline fibrinolytic activity was normal or high in all but two cases. Before haemodialysis, the response to DDAVP-infusion was greatly reduced in the majority of patients as compared with healthy controls, irrespective of the baseline level. This was in accordance with mean t-PA-antigen levels which increased only slightly after DDAVP. When DDAVP was given after haemodialysis, previous non-responders showed a normal increase in fibrinolytic activity. The level of free t-PA-inhibitors was normal in most cases as were levels of α2-antiplasmin. and α2-macroglobulin.

Key words

Plasminogen activator - t-PA-inhibitor - Haemodialysis - Nephrectomy - DDAVP
 

  • References

  • 1 Cash JD. Control mechanism of activator release. In: Progress in Chemical Fibrinolysis and Thrombolysis. Davidson JF, Rowan RM, Samama MM, Desnoyers PC. (Eds) Raven Press; New York: 1978. 3 65-75
    Search in Google Scholar
  • 2 Colucci M, Stassen JM, Salwa J, Collen D. Identification of plasminogen activator releasing activity in the neurohypophysis. Brit J Haem 1984; 58: 337-346
    CrossrefPubMedSearch in Google Scholar
  • 3 Duckert F. Urokinase. In: Fibrinolytics and Antifibrinolytics. Markwardt F. (Ed) Springer; 1978. pp 209-237
    Search in Google Scholar
  • 4 Kucinski CS, Flether AP, Sherry S. Effect of urokinase antiserum on plasminogen activators: demonstration of immunologic dissimilarity between plasma plasminogen activator and urokinase. J Clin Invest 1968; 47: 1238-53
    CrossrefPubMedSearch in Google Scholar
  • 5 Wallen P. Chemistry of plasminogen and plasminogen activation. In: Progress in Chemical Fibrinolysis and Thrombolysis. Davidson JF, Rowan RM, Samama MM, Desnoyers PC. (Eds) Raven Press; New York: 1978. 3 167-181
    Search in Google Scholar
  • 6 Collen D. On the regulation and control of fibrinolysis. Thromb Haemostas 1980; 43: 77-89
    PubMedSearch in Google Scholar
  • 7 Wijngaards G, Kluft C, Groeneveld E. Demonstration of urokinase- related fibrinolytic activity in human plasma. Br J Haematol 1982; 51: 165-169
    CrossrefPubMedSearch in Google Scholar
  • 8 Wun T-C, Schleuning W-D, Reich E. Isolation and characterization of urokinase from human plasma. J Biol Chem 1982; 257: 3276-3283
    PubMedSearch in Google Scholar
  • 9 Roblin R, Young PL. Dexamethasone regulation of plasminogen activator in embryonic and tumor-derived human cells. Cancer Res 1980; 40: 2706-2713
    PubMedSearch in Google Scholar
  • 10 Bernik MB, Wijngaards G, Rijken DC. Production by human tissues in culture of immunologically distinct, multiple molecular weight forms of plasminogen activators. Ann NY Acad Sci 1981; 370: 592-608
    CrossrefPubMedSearch in Google Scholar
  • 11 Holemans R, Mann LS, Cope C. Fibrinolytic activity of renal venous and arterial blood. Am J Med Sci 1967; 254: 330-333
    CrossrefPubMedSearch in Google Scholar
  • 12 Menon IS, Dewar HA, Newell DJ. Role of the kidney in fibrinolytic activity of blood. Lancet 1968; 1: 785-788
    PubMedSearch in Google Scholar
  • 13 Buluk K, Furman M. On the controlling function of the kidneys in fibrinolysis. Experientia 1962; 18: 146-147
    CrossrefPubMedSearch in Google Scholar
  • 14 Januszko T, Furman M, Buluk K. The kidneys and the liver as the organs regulating the fibrinolytic system of the circulating blood. Thromb Diath Haemorrh 1966; 15: 554-560
    PubMedSearch in Google Scholar
  • 15 Brommer EJ P, Barrett-Bergshoeff MM, Allen RA, Schicht I, Bertina RM, Schalekamp MA D H. The use of desmopressin acetate (DD AVP) as a test of the fibrinolytic capacity of patients - Analysis of responders and non-responders. Thromb Haemostas 1982; 48: 156-61
    PubMedSearch in Google Scholar
  • 16 Siegel-Ralston A, Astrup T. Previously undescribed fibrinolysis inhibitor in human blood. Nature New Biol 1971; 234: 180-181
    CrossrefPubMedSearch in Google Scholar
  • 17 Bergstein JM, Kuederli U, Bang NU. Plasma inhibitor of glomerular fibrinolysis in the hemolytic-uremic syndrome. Am J Med 1982; 73: 322-327
    CrossrefPubMedSearch in Google Scholar
  • 18 Kluft C. Studies on the fibrinolytic system in human plasma: quantitative determination of plasminogen activators and proactivators. Thromb Haemostas 1979; 41: 365-83
    PubMedSearch in Google Scholar
  • 19 Wijngaards G, Kluft C, Groeneveld E. Demonstration of urokinase- related fibrinolytic activity in human plasma. Br J Haematol 1982; 51: 165-169
    CrossrefPubMedSearch in Google Scholar
  • 20 Rijken DC, van Hinsbergh VW M, Sens EH C. Quantitation of tissue-type plasminogen activator in human endothelial cell cultures by use of an enzyme immunoassay. Thromb Res 1984; 33: 145-153
    CrossrefPubMedSearch in Google Scholar
  • 21 Kluft C, Vellenga E, Brommer EJ, Wijngaards G. A familial hemorrhagic diathesis in a Dutch family; an inherited deficiency of alpha2-antiplasmin. Blood 1982; 59: 1169-1180
    PubMedSearch in Google Scholar
  • 22 Verheijen JH, Mullaart E, Chang GT G, Kluft C, Wijngaards G. A simple, sensitive spectrophotemetric assay for extrinsic (tissue-type) plasminogen activator applicable to measurements in plasma. Thromb Haemostas 1982; 48: 266-269
    PubMedSearch in Google Scholar
  • 23 Verheijen JH, Rijken DC, Brommer EJ P, Chang GT G. Measurement of tissue-type plasminogen activator activity, antigen and inhibition in plasma. In: Clinical aspects of fibrinolysis and thrombolysis. Jespersen J, Kluft C, Korsgaard O. Eds South Jutland University Press; Esbjerg: 1983. pp 121-131
    Search in Google Scholar
  • 24 Kluft C, Wijngaards G, Jie AF H. Intrinsic plasma fibrinolysis: involvement of urokinase-related activity in the factor XII-indepen- dent plasminogen proactivator pathway. J Lab Clin Med 1984; 103: 408-419
    PubMedSearch in Google Scholar
  • 25 Kluft C. Blood fibrinolysis. Proactivators and activators in human plasma. Thesis; Leiden: 1978
    Search in Google Scholar
  • 26 Brommer EJ P, Barrett-Bergshoeff MM, Allen RA, Schicht I, Bertina RM, Schalekamp MA D H. The use of desmopressin acetate (DD AVP) as a test of the fibrinolytic capacity of patients - Analysis of responders and non-responders. Thromb Haemostas 1982; 48: 156-161
    PubMedSearch in Google Scholar
  • 27 Brommer EJ p, Verheijen JH, Chang GT G, Rijken DC. Masking of fibrinolytic response to stimulation by an inhibitor of tissue-type plasminogen activator in plasma. Thromb Haemostas 1984; 52: 311-314
    PubMedSearch in Google Scholar
  • 28 Lemer RG, Weseley S, Nelson JC, Kurz H, Doherty J. Fibrinolytic activity during the course of a single hemodialysis session. Haemostasis 1984; 14: 116 (Abstr)
    PubMedSearch in Google Scholar
  • 29 Stibbe J, Kluft C, Brommer EJ P, Gomes M, de Jong DS, Nauta J. Secretion of extrinsic (tissue-type) plasminogen activator by endothelial cells is the cause of enhanced fibrinolytic activity during cardiopulmonary bypass in openheart surgery. Eur J Clin Invest, 1984; 14: 375-82
    CrossrefPubMedSearch in Google Scholar
  • 30 Emeis JJ, Kluft C. PAF-aceter-induced release of tissue-type plasminogen activator from vessel walls. Involvement of a lipoxygenase pathway Haemostasis 1984; 14: 92 (Abstr)
    PubMedSearch in Google Scholar
  • 31 Brommer EJ P, Brakman P, Haverkate F, Kluft C, Traas DW, Wijngaards G. Progress in Fibrinolysis. In: Recent Advances in Blood coagulation. Poller L. (Ed) Churchill Livingstone; Edinburgh: 1981. pp 125-149
    Search in Google Scholar
  • 32 Cash J. A new approach to studies of the fibrinolytic enzyme system in man. Am Heart J 1968; 75: 424-427
    CrossrefPubMedSearch in Google Scholar
  • 33 Linder A, Charra B, Sherrard DJ, Scribner BH. Accelerated atherosclerosis in prolonged maintenance haemodialysis. N Engl J Med 1974; 290: 697-704
    CrossrefPubMedSearch in Google Scholar
  • 34 Scharf S, Wexler J, Longnecker RE, Blaufox MD. Cardiovascular diseases in patients on chronic haemodialytic therapy. Progr Cardiovasc Dis 1980; 22: 343-356
    CrossrefPubMedSearch in Google Scholar
  • 35 Editorial. Long-term survival on dialysis. Lancet 1983; 2: 889-890
    PubMedSearch in Google Scholar
  • 36 Turney JH, Woods HF, Fewell MR, Weston MJ. Factor VIII- complex in uraemia and effects of haemodialysis. Clin Res 1981; 282: 1653-6
    PubMedSearch in Google Scholar
  • 37 Bern MM, Klumpar DI, Wheeler WE, Davis GL. Factor VIII complex in chronic renal failure: influence of protein C, fibrinolysis and diabetes mellitus. Thromb Res 1983; 31: 177-186
    CrossrefPubMedSearch in Google Scholar