만성 신부전 환자에서 혈액투석 전후의 혈장 von Willebrand factor 항원 변화

Abstract

Background: Since von Willebrand factor(vWF) has been first implicated in the pathogenesis of uremic bleeding by Kazatchkine et al.(1976), several subsequent studies have demonstrated the presence of increased levels of plasma vWF in renal failure. After initiation of hemodialysis, the mortality from the uremic bleeding diasthesis improved significantly. However, there are numerous reports of life-threatening bleeding in patients undergoing chronic hemodialysis. Therefore, we evaluated the change of plasma vWF:Ag levels before and after hemodialysis. Methods: vWF:Ag concentrations were determined by enzyme linked immunoassay in pre-and posthemodialysis plasma of 20 uremic patients and 20 healthy controls. T-test was used to compare vWF:Ag concentrations of pre-vs posthemodialysis and controls vs prehemodialysis. Results: Plasma concentrations of vWF:Ag in predialysis was elevated by 114.3±24.6% compared to healthy controls(92.4 ± 17.2 %)(p=0.002). No significant difference was found between the pre-and posthemodialysis(114.3±24.6%, 118.0±19.0, respectively, p=0.4). Conclusions: Plasma concentrations of vWF:Ag in uremic patients were higher than in healthy controls. The change of plasma vWF:Ag after hemodialysis was not observed.