PMID- 11274275
OWN - NLM
STAT- MEDLINE
DCOM- 20010705
LR  - 20190513
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 16
IP  - 4
DP  - 2001 Apr
TI  - Soluble thrombomodulin is associated with viral hepatitis, blood pressure, and 
      medications in haemodialysis patients.
PG  - 787-92
AB  - BACKGROUND: The level of soluble thrombomodulin (sTM), a traditional marker of 
      endothelial injury, is also dependent on renal excretory function. We studied 
      serum sTM in chronic haemodialysis (HD) patients to determine which factors are 
      predictive of its levels in this population. METHODS AND RESULTS: sTM levels of 
      10.7 (5.72-30.7) ng/ml in 100 HD patients were higher than in 30 controls 
      (P<0.0001). In a bivariate regression analysis, immunoreactive sTM was positively 
      associated with the presence of hepatitis B virus surface antigen and/or 
      anti-hepatitis C virus antibodies measured by third generation ELISAs (P<0.0001), 
      and was related to certain markers of liver injury and biosynthetic dysfunction. 
      sTM was also directly associated with time on dialysis (P=0.001), or use of 
      unfractionated heparin (UFH) (vs enoxaparin) (P=0.0007), erythropoietin 
      (P=0.008), ACE-inhibitors (P=0.034), acetate-buffered dialysate (vs bicarbonate) 
      (P=0.040), pre-dialysis systolic (P=0.012), and diastolic blood pressure 
      (P=0.043). It was negatively associated with lipoprotein(a) (P=0.029). sTM was 
      not related to age, sex, smoking, cause of renal failure, prevalence of 
      cardiovascular disease, amount of HD delivered, preserved residual renal 
      function, ferritin, C-reactive protein, and other vasoactive medications used. In 
      a multivariable analysis, a positive hepatitis marker (P=0.0002), the use of UFH 
      (P=0.030) and erythropoietin (P=0.019), and raised pre-dialysis blood pressure 
      (P=0.024) were positive independent predictors of high sTM level. CONCLUSION: 
      These data indicate that, in addition to endothelial activation, elevated sTM 
      levels in HD patients may be related to viral infection and/or liver dysfunction, 
      and influenced by modifiable factors such as increased blood pressure, and the 
      type of heparin and erythropoietin treatment used.
FAU - Borawski, J
AU  - Borawski J
AD  - Department of Nephrology and Internal Medicine, Medical Academy, Bialystok, 
      Poland.
FAU - Naumnik, B
AU  - Naumnik B
FAU - Pawlak, K
AU  - Pawlak K
FAU - Mysliwiec, M
AU  - Mysliwiec M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Biomarkers)
RN  - 0 (Thrombomodulin)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Biomarkers
MH  - Blood Pressure
MH  - Cross-Sectional Studies
MH  - Female
MH  - Hepatitis, Viral, Human/blood/physiopathology
MH  - Humans
MH  - Kidney Diseases/*blood/*therapy
MH  - Male
MH  - Middle Aged
MH  - *Renal Dialysis
MH  - Sex Factors
MH  - Thrombomodulin/*blood
EDAT- 2001/03/29 10:00
MHDA- 2001/07/06 10:01
CRDT- 2001/03/29 10:00
PHST- 2001/03/29 10:00 [pubmed]
PHST- 2001/07/06 10:01 [medline]
PHST- 2001/03/29 10:00 [entrez]
AID - 10.1093/ndt/16.4.787 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2001 Apr;16(4):787-92. doi: 10.1093/ndt/16.4.787.