Emostasi nei pazienti diabetici e uremici: Impatto del trapianto di rene e pancreas

Translated title of the contribution: Normalization of multiple haemostatic abnormalities in uremic type 1 diabetic patients after kidney-pancreas transplantation

P. Fiorina, F. Folli, F. Bifari, M. B. Ventre, G. Finzi, G. Mazzolari, C. Fedeli, V. Guzzi, P. Della Valle, C. Placidi, D. Belloni, E. Ferrero, C. Capella, A. D'Angelo, Antonio Secchi

Research output: Contribution to journalArticle

Abstract

Background and aims. To evaluate the effects of kidney or kidney-pancreas transplantation on platelet and haemostatic abnormalities in uremic type 1 diabetic patients, we conducted a cross-sectional study involving 12 type 1 diabetic patients (T1DM), 30 uremic type 1 diabetic patients (U-T1DM), 27 uremic type 1 diabetic kidney-pancreas transplanted patients (KP), 12 uremic type 1 diabetic kidney-alone transplanted patients (KD), 13 healthy controls (C). Method and result. We evaluated platelet and function, including intracellular calcium level, and clotting system. Resting calcium level were significantly higher in U-T1DM and KD group than KP/C groups (U-T1DM = 137.6 ± 11.2, KD = 133.3 ± 16.6, T1DM = 60.9 ± 7.7, KP = 97.2 ± 9.2, C = 72.0 ± 11.0 nM, p < 0.01). CD41 expression was significantly reduced in platelet from U-T1DM group compared to the other groups (U-T1DM = 53.2 ± 7.7%, KP = 75.7 ± 6.2%, KD = 80.4 ± 4.3%, C = 81.6 ± 2.2%, T1DM = 82.6 ± 3.4%, p < 0.05). Diabetic patients showed higher levels of thrombin platelet expression than non diabetic patients. Levels of hypercoagulability markers in the KP group, and to a lesser extent KD group but not the U-T1DM group, were similar to those of the C group. A reduction in the natural anticoagulants was evident in U-T1DM group, while near-normal values were observed in KP and KD groups. Conclusions. Haemostatic abnormalities were not observed in KP patients, but were present in KD patients and in U-T1DM patients. This could contribute to the lower cardiovascular mortality observed in KP patient compared to KD and U-T1DM patients.

Translated title of the contributionNormalization of multiple haemostatic abnormalities in uremic type 1 diabetic patients after kidney-pancreas transplantation
Original languageItalian
Pages (from-to)43-50
Number of pages8
JournalGiornale Italiano di Diabetologia e Metabolismo
Volume24
Issue number2
StatePublished - Jun 2004

Keywords

  • Anticoagulant activity
  • Haemostatic abnormalities
  • Platelets
  • Type 1 diabetes mellitus
  • Uremia

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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  • Cite this

    Fiorina, P., Folli, F., Bifari, F., Ventre, M. B., Finzi, G., Mazzolari, G., Fedeli, C., Guzzi, V., Della Valle, P., Placidi, C., Belloni, D., Ferrero, E., Capella, C., D'Angelo, A., & Secchi, A. (2004). Emostasi nei pazienti diabetici e uremici: Impatto del trapianto di rene e pancreas. Giornale Italiano di Diabetologia e Metabolismo, 24(2), 43-50.