Association between uremic toxin-anthranilic acid and fibrinolytic system activity in predialysis patients at different stages of chronic kidney disease

被引:25
作者
Kaminski, Tomasz W. [1 ]
Pawlak, Krystyna [2 ]
Karbowska, Malgorzata [1 ]
Mysliwiec, Michal [3 ]
Grzegorzewski, Waldemar [4 ]
Kuna, Jakub [4 ]
Pawlak, Dariusz [1 ]
机构
[1] Med Univ Bialystok, Dept Pharmacodynam, 2C Mickiewicza Str, PL-15089 Bialystok, Poland
[2] Med Univ Bialystok, Dept Monitored Pharmacotherapy, Bialystok, Poland
[3] Med Univ Bialystok, Dept Nephrol & Clin Transplantat, Bialystok, Poland
[4] Univ Warmia & Mazury, Dept Pharmacol & Toxicol, Fac Med Sci, Olsztyn, Poland
关键词
Anthranilic acid; Fibrinolysis; Renal failure; Hemostasis; Fibrinolytic capacity; PLASMINOGEN-ACTIVATOR RECEPTOR; CARDIOVASCULAR-DISEASE; TRYPTOPHAN-METABOLISM; RHEUMATOID-ARTHRITIS; KYNURENINE PATHWAY; UPA/SUPAR SYSTEM; INDOXYL SULFATE; UROKINASE; PLASMA; HYPERFIBRINOLYSIS;
D O I
10.1007/s11255-017-1729-1
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Chronic kidney disease (CKD) is an estimated risk factor for increased mortality and morbidity due to fibrinolytic system disturbances. Progressive loss of renal function leads to retention of uremic toxins. Anthranilic acid (AA) is a tryptophan-derived uremic toxin with multidirectional properties that can affect the hemostatic system. The goal of this study was to examine the association between AA and the parameters of fibrinolysis at different stages of CKD. Patients with CKD were divided into two groups: mild-to-moderate (n = 20) and severe-to-end-stage CKD (n = 28). Seventeen healthy volunteers served as an additional control group. Parameters of fibrinolysis, inflammation, and monocytes activation were determined by ELISA immune-enzymatic kits. AA levels were evaluated using high-performance liquid chromatography. AA concentration and parameters of fibrinolysis: urokinase-type plasminogen activator (uPA), its soluble receptor (suPAR), tissue plasminogen activator (tPA), tissue plasminogen activator inhibitor-1 (PAI-1) and plasmin-antiplasmin complex (PAP) were significantly elevated in the CKD groups compared with the controls. The markers of inflammation, monocyte activation, and impaired kidney function were also increased in those with CKD. AA was positively correlated with the uPA/suPAR system in the early stages of CKD, whereas during severe-to-end-stage CKD, inverse relationships were observed between AA, tPA and PAI-1. Additionally, AA was an independent variable associated with tPA in patients with CKD overall and with uPA levels in the mild-to-moderate CKD group. Obtained results suggest for the first time the association between AA and the fibrinolytic system in CKD patients. The distinct relationship between AA and individual parameters of fibrinolysis appears to be dependent on CKD stage.
引用
收藏
页码:127 / 135
页数:9
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