RESUMO
Platelet surface receptors for von Willebrand factor and for fibrinogen (glycoproteins GPIb and GPIIb/IIIa) were studied with monoclonal antibodies CD42 and CD41 and cytofluorometry in 31 healthy subjects, 10 hemodialysis patients with no A-V fistula obstruction (patent original fistula), 10 hemodialysis patients with frequent A-V fistula obstruction (more than twice), 12 patients with mild chronic renal failure (creatinine 1.75 +/- 0.40 mg/100 ml), 11 patients with advanced chronic renal failure (creatinine 5.62 +/- 1.22 mg/100 ml), and 10 patients with end-stage renal disease (ESRD) treated with peritoneal dialysis. There was a significant increase of platelet surface glycoproteins GPIb and GPIIb/IIIa in the population of hemodialysis patients with frequent A-V fistula obstruction. The expression of these platelet receptors might be related to the prothrombotic tendency of a group of patients with ESRD, who suffer more occlusive and thrombotic events of the A-V fistula. This group of patients may also have a higher frequency of systemic thrombotic and atherosclerotic complications.
Assuntos
Fístula Arteriovenosa/fisiopatologia , Plaquetas/metabolismo , Fibrinogênio/metabolismo , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/biossíntese , Complexo Glicoproteico GPIb-IX de Plaquetas/biossíntese , Fator de von Willebrand/metabolismo , Anticorpos Monoclonais/imunologia , Proteínas Sanguíneas/metabolismo , Citometria de Fluxo , Humanos , Falência Renal Crônica/imunologia , Diálise Peritoneal/efeitos adversos , Agregação Plaquetária , Diálise Renal/efeitos adversosRESUMO
A case of idiopathic Bence-Jones proteinuria with a follow-up of nine years without evidence of lymphoproliferative disorder is discussed.