Abstract
Background:
Chronic kidney disease patients show changes in the endothelial surface layer (ESL). Whether hemodialysis (HD) itself or low molecular weight heparins (LMWH) induce ESL alterations is unknown.
Methods:
We studied the ESL in 20 HD patients with Sidestream Dark Field Imaging [measuring perfused boundary region (PBR)] and measurement of ESL constituents in plasma during HD in 2 studies. LMWH was administered at the start of HD in study A, and 120 min after the start of HD in study B. Mean platelet volume (MPV) and platelet large cell ratio (P-LCR) were also measured.
Results:
Syndecan-1 increased significantly 30 min after LMWH administration. sP-Selectin increased 120 min after HD start, and MPV and P-LCR decreased significantly during HD. No significant changes of PBR, sE-Selectin, sICAM-1, or sVCAM-1 were perceived.
Conclusions:
HD caused a significant increase in Syndecan-1 without a change in PBR. The administration of LMWH appeared to precede the rise in Syndecan-1.
© 2014 S. Karger AG, Basel.
MeSH terms
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Aged
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Aged, 80 and over
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Anticoagulants / adverse effects*
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Anticoagulants / pharmacology
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Anticoagulants / therapeutic use
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Dialysis Solutions / chemistry
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E-Selectin / blood
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Endothelium, Vascular / drug effects
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Endothelium, Vascular / injuries
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Endothelium, Vascular / ultrastructure*
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Female
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Glycocalyx / drug effects
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Glycocalyx / ultrastructure
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Hemoglobinometry / instrumentation
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Hemoglobinometry / methods
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Humans
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Intercellular Adhesion Molecule-1 / blood
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Male
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Mean Platelet Volume
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Microcirculation
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Microscopy / instrumentation
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Microscopy / methods
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Middle Aged
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Mouth Floor / blood supply
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Nadroparin / adverse effects*
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Nadroparin / pharmacology
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Nadroparin / therapeutic use
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P-Selectin / blood
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Point-of-Care Systems
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Renal Dialysis / adverse effects*
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Renal Dialysis / methods
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Renal Insufficiency, Chronic / blood
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Renal Insufficiency, Chronic / pathology*
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Renal Insufficiency, Chronic / therapy
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Sampling Studies
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Syndecan-1 / blood*
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Vascular Cell Adhesion Molecule-1 / blood
Substances
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Anticoagulants
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Dialysis Solutions
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E-Selectin
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Nadroparin
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P-Selectin
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SDC1 protein, human
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SELE protein, human
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Syndecan-1
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Vascular Cell Adhesion Molecule-1
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Intercellular Adhesion Molecule-1