Changes in Fibrinmonomer and Fibrin Structure in Patients with Renal Failure

Abstract

Procedure: 54 patients subdivided in 3 groups were investigated: 1) 10 patients with acute renal failure. 2) 36 patients with chronic renal failure (serum Creatinin >5mg%). 3) 8 patients before and one hour after hemodialysis.Fibrinmonomer and fibrin structure were studied by SDS-polyacrylamidgele-lectrophoresis according to Weber and Osborne. In addition factor XIII activity was determined immunologically according to the method of Bohn and Haupt. Results: 1)Patients with acute renal failure showed a defective structure of fibrin with loss of polymerisation of the α-ehains but normal γ -dimers. In these patients factor XIII activity was lower than 60%. 2) In 21 out of 36 patients with chronic renal failure, fibrin polymerisation was incomplete though no factor XIII deficiency could be determined. 3) The changes in fibrin polymerisation could be demonstrated before as well as after hemodialysis. Conclusions: 1)In acute renal failure, factor XIII deficiency induces an incomplete α-chain polymerisation of fibrin. 2) In chronic renal failure, the deficient α-chain polymerisation may be caused by an inhibitor which is not dialysable.