Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Abstract

A prothrombotic state has been demonstrated in uremic patients undergoing conservative treatment or dialysis and could act as a cardiovascular risk factor in these patients. This study was performed in hypertensive patients with mild to moderate impairment of renal function to investigate at what stage of renal failure abnormalities of the coagulation system develop and whether these abnormalities are associated with increased prevalence of cardiovascular events in these patients. Renal function was assessed in 382 essential hypertensive patients by measurement of 24-hour creatinine clearance (Cr Cl), urinary protein excretion, and microalbuminuria. In these patients we assessed the prevalence of atherosclerotic disease and evaluated the overall function of the coagulation system by measurement of platelet counts, PT, PTT, antithrombin III, fibrinogen, D-dimer, and prothrombin fragment 1+2 (F1+2). Mild renal failure, as indicated by Cr Cl from 30 to 89 ml/min per 1.73 m2 of body surface area, was found in 168 of 382 patients. Age, blood pressure, duration of hypertension, and plasma concentrations of fibrinogen, D-dimer and F1+2 were significantly greater in hypertensive patients with mild renal failure than in those with normal renal function and this difference persisted after adjustment for potential confounders. Cr Cl was significantly and inversely correlated with plasma fibrinogen (rho= -0.260, P<0.001), D-dimer (rho=-0.334, P<0.001), and F1+2 (rho= -0.196, P<0.001) levels. Multiple regression analysis showed that plasma fibrinogen (F=6.31; P=0.009) and D-dimer (F=9.347; P=0.003) levels were correlated to renal function independent of age, blood pressure, duration of hypertension, triglyceride levels, urinary protein excretion, and erythrocyte sedimentation rate. The prevalence of coronary artery, cerebrovascular, and peripheral vascular disease was significantly greater in patients with mild renal failure than in those with normal renal function. Elevated levels of fibrinogen and D-dimer were associated with the presence of atherosclerotic disease independent of renal function and other risk factors. Thus, increased plasma levels of fibrinogen, D-dimer, and F1+2 are present in hypertensive patients with mildly decreased creatinine clearance, suggesting a prothrombotic state that may contribute to the risk for atherosclerotic disease at all levels of renal function.

Fibrinogen, D-dimer, Prothrombin fragment 1+2
This content is only available as a PDF.
© American Journal of Hypertension, Ltd. 2001
Topic:
Issue Section:
Abstracts
You do not currently have access to this article.
Download all slides