Protein Z and natural anticoagulants in children on peritoneal dialysis and hemodialysis |
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Authors: | Kenan Bek Ozan Özkaya Tunç F??g?n Yüksel Aliyaz?c?o?lu M ?ükrü Paksu Tolga Özgen Davut Albayrak Kemal Baysal |
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Institution: | (1) Department of Pediatric Nephrology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey;(2) Department of Pediatric Hematology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey;(3) Department of Biochemistry, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey;(4) Department of Pediatrics, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey;(5) Department of Pediatric Cardiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey |
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Abstract: | Hemostatic alterations due to abnormalities in the coagulation and fibrinolytic system may occur in dialysis patients. Protein
Z (PZ) is a vitamin K-dependent coagulation protein promoting assembly of thrombin with phospholipid vesicles. The aim of
this study was to investigate PZ and natural anticoagulants in children on hemodialysis (HD) and peritoneal dialysis (PD).
Protein Z, protein C (PC), protein S (PS), antithrombin III (AT III), and fibrinogen levels were studied in 24 PD, 13 HD patients
and 23 controls. Plasma PZ levels in patients on HD were significantly higher than those on PD and control group (p = 0.04,
p = 0.03). We observed elevated PC, PS and AT III activities in children on PD when compared to controls (p = 0.011, p = 0.003,
p < 0.001). In HD patients, only PS activity was increased compared to controls (p = 0.016). PC and PS activities did not
differ between PD and HD patients whereas AT III activity was higher in PD patients compared to HD patients (p < 0.001). Normal/high
levels of PC, PS and AT III suggest that children on PD or HD treatment do not seem to have an increased risk of thrombogenesis
due to reduction of these proteins. Increased PZ levels, however, might contribute to the hemostatic alterations in children
on HD treatment along with other well known abnormalities. |
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Keywords: | Antithrombin III Children Hemodialysis Peritoneal dialysis Protein C Protein S Protein Z |
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