Rouba Farajallah Manachi and Rasha Aguib Hassan
Background: Evaluating ADAMTS13 activity in chronic kidney diseases patients could provide insights into their susceptibility to thrombotic events. This work set out to analyze ADAMTS13 (or von Willebrand factor-cleaving protease, von Willebrand Factor-Cleaving Protease activity in plasma to gauge its effectiveness as a thrombosis risk marker in pediatric chronic kidney disease patients.
Methods: In this case-control study, 60 children under 18 with chronic kidney diseases both those on dialysis and those on conservative therapy-were enrolled. The study grouped participants as follows: Group I consisted of children with chronic kidney diseases on haemodialysis; Group II comprised chronic kidney diseases patients managed conservatively via the Schwartz formula; and Group III comprised healthy children from outpatient clinics.
Results: Patients exhibited lower blood pressure, pH, and bicarbonate, as well as metabolic acidosis in some groups. ADAMTS13 (von Willebrand Factor-Cleaving Protease) enzyme levels were progressively lower across the patient groups, and were especially low in those who experienced thrombosis. Patients also showed decreased hemoglobin, glomerular filtration rate, and calcium, along with increased creatinine, urea, potassium, and phosphorus. ADAMTS13 was inversely correlated with age, renal failure duration, and impaired kidney function, but positively associated with diastolic BP and calcium.
Conclusions: Chronic kidney diseases patients had significantly lower plasma ADAMTS13 (von Willebrand Factor-Cleaving Protease) activity levels compared to healthy controls. Levels were even lower in hemodialysis patients versus chronic kidney diseases patients on conservative therapy. A significant positive association between ADAMTS13 activity and glomerular filtration rate. Moreover, ADAMTS13 activity was significantly reduced in hemodialysis patients who had thrombosis in contrast to those who were free from such complications.
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