EVALUATION OF TISSUE PLASMINOGEN ACTIVATOR INHIBITOR-1 AND FIBRINOGEN IN CHRONIC RENAL FAILURE UNDER REGULAR HAEMODIALYSIS
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This study was conducted to obtain information on the tissue plasminogen activator inhibitor-1 (PM-1) and fibrinogen levels in chronic renal failure patients on regular hoemodialysis in a trial to find out any changes that might contribute to thrombosis and bleeding. This study was conduced on 40 chronic renal failure patients on regular hemodialysis (HD) thrice weekly fow- hours each, with acetate based dialysate for about 1-13 years prior to the study. The study group consisted of 20 men and 20 women, 27 to 73 years old. The hemodialysis prescription was 12 to 13.5 h/wk, with the use of 1.1 - to 1.3 m2 cuprophane hollow -fibre dialyser. The dialyzers were not reused. In addition to 10 healthy volunteers with matched age and sex as a control group. The main causes of chronic renal failure were hypertensive glomerulosclerosis and diabetic nephropathy disease in most of the patients. All patients were anwic and under treatment by heparin on the dialysis sessions ranging from 7500- 15000 IU. Hemodialysis (HD) was peiformed with volumetrically controlled machines. In our work the assessment of plasma fibrinogen levels in the study group are significantly increase after hoPmodinl _Isis in comparison to before hoemodialysis (Ps aan). However plasma fibrinogen levels showed non significant change be- tween shidy group and control group (P> 0.05). In this study plasma plasminogen activator inhibitor -1 (PM-1) levels revealed high significant decrease after haemodialysis in comparison to before haPrnodialysis (P < 0.001). Plasma plasminogen activator inhibitor-1 (PM-1) levels revealed significant decrease before and after haemodialysis compared to controls (P < 0.001). In conclusion: coagulation and fibrinolysis are enhanced on regular haemodialysis treated (RD?) patients, a majority of patients on dialysis are in a hemostatic disturbance state, which need careful adjustment of an anticoagulant regimens, by the lowering of plasma level of tissue plasminogen activator inhibitor-1 (tPAI-1), there is tendency to bleeding rather than thrombosis in regular hnemodinl _Isis treatment patients.