Determination Of VWF And VWF-CP In Patients With Different Kinds Of Chronic Kidney Diseases(CKD)

[Object] There exist hemostatic in chronic renal disease. It is related withcoagulation and fibrinolytic system. Different renal diseases have different pathcology andpathogenesis, thus result in different kind of thrombus. Many researches indicate thatalmost all the renal disease patients get a VWF rise in the blood plasma. It is known aboutthe significant relationship between VWF-CP and VWF. Von Willebrand Factor-cleaving(VWF-CP) is a newly found and cloned enzyme in ADAMTS family, named asADAMTS13, which is the mainly protease cleaving VWF in plasma. It is the main proleaseto retrograde VWF polymer in blood plasma, in the way of adjusting the parts of VWFand the adherence of subendothelium and platelet. ADAMTS13's significance in differentkinds of renal diseases is still uncertain. And it's doubtful whether it takes part in bloodplatelet in every kind of renal disease. We have discussed the discipline VWF-CP ischanging in CKD and VWF-CP's effect in CKD mechanism.[Method] we choosing 184 patients with different kinds of renal disease according toK/DOQI made by NKF(90 patients were men, 94 patients were women. 19 lupusnephritis patients, 25 nephrotic syndrome patients, 38 chronic glomerulonephritis patients,45 DN patients, 45 CRF patients), 12 kidney transplantation patients and 40 healthy blooddonors or physical examinees as counterparts. Then we detect the activity of VWF-CP indifferent kinds of renal disease patients in the way of R-CBA. the level of VWF in themwas checked by colorimetric enzyme-linked immunosorbent assay. After that, weanalyze the statistics relatively.[Result](1) Evaluation of VWF and VWF-CP in CKD.The mean values of VWF and VWF-CP in normal controls were 71.3±49.5% and86.6±10.8% respectively. Compared with normal controls, VWF in all kinds of kidneydiseases were significantly increased, especially in nephritic syndrome(NS)and lupus nephritis(LN). Meanwhile, VWF-CP in all kinds of kidney disease were significantlyreduced, especially in LN and NS.(2) Alternation of VWF-CP during therapy.Either VWF or VWF-CP in patients before kidney transplantation, 1 and 2weeks after kidney transplantation were not changed. However VWF and VWF-CP weresignificant recovered in patients with LN after 8 weeks of therapy.(3) The differences of VWF and VWF-CP in chronic kidney diseases accordingto renal function.There was a difference in the activities of VWF-CP between patients with kidneydisease whose kidney function was in phaseⅡandⅢand those in phaseⅠ,ⅣandV(P＜0.05). But no difference could be found in VWF: Ag.(4) VWF-CP activity in kidney disease with different pathogenetics.18 LN patients were classified with renal biopsy. Patients in phaseⅣhad highestVWF: Ag among patients in other phases, while VWF-CP was deceased in phaseⅡ. On theother hand, VWF-CP was lower in MN group than in other groups. But VWF: Ag showedNo difference in other patients.(5) The results showed that VWF and VWF-CP in CKD were inverse correlation(r=-0.73, P＜0.05).[Conclusion]1,The VWF-CP activity of LN and NS patients is lowered most obviously, in whichⅥ, LN and MN patients are most serious.2,Medical cure accordingly is helpful to recover the activity of their VWP-CP.3,The change of VWP-CP has certain relation with renal function, especially forVWP-CP activity of CRF.4,The results showed that VWF and VWF-CP in CKD were inverse correlation.5,VWF-CP is related with different renal pathogenesis diseases.