Abstract
To test the effect of anticoagulants on the release of cell-mediated factors generated during hemodialysis, we measured plasma β thromboglobulin (βTG), platelet factor 4 (PF4), C3a and PMN elastase (PMNe) at 2min (pre) and 15min (or 120min for PMNe) after the start, in both venous (V) and arterial (A) samples from 9 patients undergoing two consecutive courses of dialysis. Heparin (HEP) was used for the 1st dialysis and nafamostat mesilate (FUT) for the 2nd. The results were compared between HEP vs FUT and examined by paired t-test. The V-A difference in βTG during HEP dialysis was 584±233 (ng/ml, M±SE), which was significantly greater than that of FUT dialysis, 207±175 (p<0.05). The V-A difference in PF4 was greater during HEP dialysis, 231±65ng/ml, and was only 59±46 on FUT dialysis. The V-pre difference in βTG was also significantly greater on HEP dialysis than on FUT dialysis. PMNe and C3a increased during hemodialysis in both groups.
Conclusion (1) Increased platelet activation during HEP dialysis, as compared to FUT dialysis, is suggested by these data. (2) The clinical dosage of FUT during dialysis was insufficient to prevent PMNe and C3a elevations.
