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[Disruption of regulatory possibilities of the plasma kallikrein-kinin system in chronic kidney failure and during hemodialysis].

Activation of the kallikrein-kinin system was detected in chronic renal failure treated by routine therapy. In blood plasma of the patients with chronic renal failure, kallikrein was activated from 34.2 to 63.2 mU/ml, while activity of prekallikrein was decreased from 382.0 to 117.8 mU/ml; BAEE-esterase and elastase-like activities simultaneously increased from 340 +/- 20 to 464 +/- 43 mU/ml and from 150 +/- 20 to 340 +/- 18 mU/ml, respectively. In the patients on hemodialysis during the interdialysis period, there were reductions of BAEE-esterase and kallikrein activities to 265.8 +/- 18.5 and 25.9 mI/ml, respectively; and the content of prekallikrein remained decreased. During hemodialysis the elastase-like activity was markedly increased up to 501 mU/ml due to leukocyte activation. The findings suggest that during hemodialysis, due to leukocytic elastase, there is a possible occurrence of thromboses as a result of a potential depletion of the kallikrein-kinin system and decreased blood antiproteolytic potential, including antithrombin III.