Nephrology Dialysis Transplantation, Vol 13, Issue 8 2053-2058, Copyright © 1998 by Oxford University Press
S Kim, W Yang, S Lee, H Chi and J Park
Background. This study was performed to evaluate the
relationship between serum albumin and plasma concentration of haemostatic
factors and the effect of raising serum albumin on haemostatic factors
synthesized in the liver in CAPD patients. Methods. We
measured blood levels of albumin, fibrinogen, factor II, factor VII,
protein C, free protein S, plasminogen, &agr;2-antiplasmin and
antithrombin III in 103 CAPD patients and 30 normal controls. Twenty-two
patients with albumin lt;3.5 g/dl were divided into two groups. In the
experimental group (n = 11), haemostatic factors and
albumin were measured before, after repeated infusion of 20% albumin 100 ml
three times per week for 2 weeks, and 4 weeks after withdrawal of albumin
infusion. The same parameters were measured in the control group
(n = 11) which did not receive albumin infusion.
C-reactive protein and haematocrit were followed in both groups as an
indicator of acute phase reactant and an indirect measure of volume status.
Results. CAPD patients as a whole had lower albumin
and higher fibrinogen and factor VII than normal controls. A significant
inverse correlation was present between fibrinogen and albumin
(r = -0.27, P <0.01).
Albumin in the experimental group increased from 2.7 ± 0.4 to
3.5 ± 0.6 g/l at the end of its repeated infusion and
haematocrit decreased from 26.6 ± 4.4 to 24.9 ± 5.2%.
Fibrinogen and factor VII decreased significantly, even after correction
for haematocrit (624 ± 96 vs 556
± 91 mg/dl, 160 ± 36 vs 121
± 44%, P <0.05). Four weeks after
withdrawal of albumin infusion, serum albumin decreased to 2.7 ±
0.5 g/dl, whereas fibrinogen and factor VII increased to 619 ±
78 mg/dl and 158 ± 32%, respectively (P
&;lt;0.05). Albumin, haematocrit and haemostatic factors in the control
group did not change. CRP was stable during the study period in both
groups. Conclusion. These findings indicate that
hypoalbuminaemia is an important trigger factor in the elevation of
fibrinogen, and possibly factor VII, in CAPD patients. Keywords:
albumin; CAPD; factor VII; fibrinogen
ORIGINAL ARTICLES
Effect of increasing serum albumin on haemostatic factors synthesized in the liver in CAPD patients
Department of Internal Medicine and Clinical Pathology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea; Correspondence to: SB Kim, Department of Internal Medicine, University of Ulsan, College of Medicine, Song-Pa, PO Box 145, Seoul 138-040, Korea
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