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Haemostasic markers in amyloid vs non‐amyloid uraemic patients on maintenance haemodialysis

Summary: Haemostatic disturbances effect the prognosis in end‐stage renal disease. Several biological markers of blood coagulation and fibrinolysis have been described for quantitative determination of in vivo coagulation, including plasmin‐α2‐antiplasmin complex (PAP), D‐dimer, prothrombin fragment1+2 (PF 1.2) and thrombin‐antithrombin III complex (TAT). to investigate the influence of uraemia and/or amyloidosis on haemostatic system, eight patients (aged 31 ± 6 years) with systemic amyloidosis and 12 non‐amyloid patients (aged 36 ± 7 years) with end‐stage renal disease and 11 healthy volunteers (aged 36 ± 10 years) with normal renal functions as controls, constituted the study group. Mean plasma PAP concentration has been found to be elevated significantly in uraemic amyloid patients, when compared to that of non‐amyloids and normal subjects. In the uraemic patient group (amyloid vs non‐amyloid) mean plasma concentrations of Ddimer, PF 1.2 and TAT were not statistically different whereas these values were significantly higher than that of healthy controls. It is concluded that elevated in vivo coagulation markers (D‐dimer, PF 1.2 and TAT) favours an increased risk of thrombosis in uraemia, and PAP (the biomarker of active fibrinolysis) may indicate an additional risk of haemorrhagic tendency in amyloid patients in end‐stage renal failure.