日本腎臓学会誌
Online ISSN : 1884-0728
Print ISSN : 0385-2385
ISSN-L : 0385-2385
保存期慢性腎不全患者における凝固・線溶系に関する研究
―慢性糸球体腎炎と糖尿病性腎症の比較―(多施設共同研究)
長宅 芳男, 槇野 博史, 頼岡 徳在, 堅村 信介, 大澤 源吾, 山木戸 道郎, 川崎 寛中, 加藤 譲, 松崎 益徳, 四方 賢一, 上枡 次郎, 宗宮 基, 藤井 善蔵, 林田 重昭, 那須 誉人, 大藪 靖彦, 新田 豊, 川西 秀樹, 碓井 公治, 藤原 謙太, 高杉 敬久, 金原 幸司, 浜口 直樹, 熊谷 功, 市川 晴夫, 高橋 真紀, 大森 浩之, 有元 克彦, 味埜 泰明, 川端 研治, 赤木 正彦, 前田 貞亮, 太田 善介
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1997 年 39 巻 5 号 p. 474-482

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To clarify the abnormalities of coagulation and fibrinolytic systems in predialysis patients with chronic renal failure, we measured indices of coagulation and fibrinolytic systems in 33 predialysis patients whose creatinine (Cr) levels were over 3.0 mg/dl. We termed twenty-four patients with chronic glomerulonephritis the "CGN group". We also termed nine patients with diabetes mellitus the "DM group". We measured thrombin •antithrombin III complex (TAT), α2 plasmin inhibitor plasmin complex (PIC), D-dimer, protein C, protein S, thrombomodulin (TM), vitronectin, tissue plasminogen activator •plasminogen activator inhibitor-1 complex (tPAI-C) in these two groups. Furthermore, we measured the same indices after 6 months in the CGN group. As a result, the plasma levels of both TAT, PIC, TM/Cr ratio in the DM group were significantly higher than those in the CGN group. In the CGN group, changes in both protein S activities and plasma levels of tPAI-C were reduced significantly after 6 months. In conclusion, the abnormalities of coagulation and fibrinolytic systems in predialysis diabetic patients were stronger than those in predialysis patients with CGN. Furthermore, these abnormalities were worsened after 6 months in predialysis patients with chronic renal failure.

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