Natural anticoagulant and antifibrinolysis in patients with chronic renal failure with and without hemodialysis

A study of factor II, V, VII, X, protein C, protein S, alpha[1]-antitrypsin and alpha[2]-macroglobulin were carried on patients with chronic renal failure on conservative treatment or hemodialysis twice or thrice/week to evaluate their natural anticoagulant and fibrinolysis in comparison with healthy normal group. In conservative group, factor II, V, VIII, X clotting time, antithrombin III activity increased significantly compared to normal group, where protein C activity, total protein S concentration alpha[1] antitrypsin were decreased significantly. In the twice/week hemodialysed group, there was no statistical significant difference in factor II, V, VIII, X, antithrombin III activities than normal group but with a significant increase than the conservative group. Protein C activity significantly decreased, protein S total concentration significantly increased and alpha[2]-macroglobulin concentration significantly increased compared to normal control group. In the thrice/week hemodialysed group, there was no significant change in factor II, V activity but there was a significant decrease in factor VIII, X activity, antithrombin Hi activity, protein C activity than normal control group. An increase in the concentration of total protein S, alpha[1]-antitrypsin, alpha[2]-macroglobulin than normal control group was demonstrated. Coagulation activity was significantly increased in chronic renal failure patients on hemodialysis with decrease in the natural anticoagulant and increase in antifibrinolysis

Study of protein C changes in prolonged maintenance hemodialysis patients

Estimation of protein C [PC] activity, antigen, plasminogen activators, concentration and serum creatinine were determined in fifteen hemodialysis patients compared to fifteen healthy controls [age and sex matched]. The previous estimation were performed before and two hours after dialysis. Before dialysis, PC activity and plasminogen activators were depressed, whereas PC antigen showed insignificant changes from controls. On the other hand, plasminogen concentration and serum creatinine were significantly elevated. After dialysis, all tested parameters showed insignificant changes from controls. These findings suggest the presence of one or more inhibitors against PC activity in plasma in patients with chronic renal failure which illustrates the altered hemostatic equilibrium in chronic hemodialysis patients

Study of the natriuresis of fasting and its practical application in the management of refractory obesity

Previous prefast preparations to eliminate the surplus sodium in order to study the true saluresis of fasting resorted to the use of Kempner rice diet. The pattern of the natriuresis of fasting could be changed by the use of a new method of prefast preparation in which cadbohydrate is eliminated and the surplus sodium is mopped up by the use of diuretics. This is taken as an evidence that carbohydrate exerts an effect on the saluresis of fastitog not only after fasting but also in the prefast period. By excluding the carbohydrate load inherent in the kempner prefast, naturesis was noticed to start on the first day instead of the second day, thereby bringing it down to the sphere of practical applicability in the management of obesity . By sparing this first day the one day a week fast assumes a practical value