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.

Emostasi nei pazienti diabetici e uremici: Impatto del trapianto di rene e pancreas / 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, A. Secchi. - In: GIDM. GIORNALE ITALIANO DI DIABETOLOGIA E METABOLISMO. - ISSN 1593-6104. - 24:2(2004), pp. 43-50.

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

P. Fiorina;F. Folli;F. Bifari;D. Belloni;E. Ferrero;A. Secchi
2004

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.
Anticoagulant activity; Haemostatic abnormalities; Platelets; Type 1 diabetes mellitus; Uremia; Internal Medicine; Endocrinology, Diabetes and Metabolism; Endocrinology
Settore MED/09 - Medicina Interna
GIDM. GIORNALE ITALIANO DI DIABETOLOGIA E METABOLISMO
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/468574
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