Thromb Haemost 1995; 73(05): 763-767
DOI: 10.1055/s-0038-1653865
Original Articles
Clinical Studies
Schattauer GmbH Stuttgart

Marked Increase of Activated Factor VII in Uremic Patients

Kazuomi Kario
1   The Department of Internal Medicine, Hyogo Prefectural Awaji Hospital, Sumoto, Hyogo, Osaka, Japan
2   Awaji-Hokudan Public Clinic, Hokudan, Tsuna, Hyogo, Osaka, Japan
,
Takefumi Matsuo
1   The Department of Internal Medicine, Hyogo Prefectural Awaji Hospital, Sumoto, Hyogo, Osaka, Japan
,
Miyako Matsuo
1   The Department of Internal Medicine, Hyogo Prefectural Awaji Hospital, Sumoto, Hyogo, Osaka, Japan
,
Masanobu Koide
1   The Department of Internal Medicine, Hyogo Prefectural Awaji Hospital, Sumoto, Hyogo, Osaka, Japan
,
Tsutomu Yamada
1   The Department of Internal Medicine, Hyogo Prefectural Awaji Hospital, Sumoto, Hyogo, Osaka, Japan
,
Shin Nakamura
3   Primate Research Institute, Kyoto University, Inuyama, Aichi, Osaka, Japan
,
Toshiyuki Sakata
4   Clinical Laboratory, Osaka, Japan
,
Hisao Kato
5   Research Institute, National Cardiovascular Center, Fujishirodai, Suita, Osaka, Japan
,
Toshiyuki Miyata
5   Research Institute, National Cardiovascular Center, Fujishirodai, Suita, Osaka, Japan
› Author Affiliations
Further Information

Publication History

Received 10 October 1994

Accepted after resubmission 08 February 1995

Publication Date:
09 July 2018 (online)

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Summary

We investigated plasma activated factor VII (FVIIa) levels in uremic patients (nondialysis group: n = 38; dialysis group: n = 36) and healthy controls (n = 32). We also measured the plasma levels of thrombomodulin (an indicator of endothelial cell injury) and tissue factor. Plasma FVIIa showed a marked increase in the nondialysis group (mean [95% confidence interval]: 4.6 [4.1-5.1] ng/ml, p <0.0001) with the progressive impairment of renal function, as indicated by the serum creatinine level, when compared with the 32 controls (2.8 [2.5-3.1] ng/ml), and was further increased in the dialysis group (6.1 [5.5-6.8] ng/ml, p <0.001 vs. nondialysis group). Plasma levels of thrombomodulin and tissue factor were also higher in the nondialysis group than the control group, and were further increased in the dialysis group. Plasma tissue factor levels did not show any correlation with FVIIa or thrombomodulin in both the nondialysis and dialysis groups. Thus, circulating tissue factor appears to be released by a different mechanism from thrombomodulin and may not contribute to the direct activation of factor VII in uremic patients. On the other hand, the plasma level of thrombomodulin was positively correlated with that of FVIIa in the nondialysis group, and this correlation was independent of renal function. Thus, enhanced conversion of factor VII zymogen to FVIIa, probably related to endothelial cell injury, may be a risk factor for cardiovascular events in uremic patients.