The effects of gemfibrozil upon the hypercoagulable state in dyslipidaemic patients with chronic renal failure

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
A B Irish, C H Thompson

Abstract

The dyslipidaemia of chronic renal disease could contribute to a hypercoagulable state by activation of blood coagulation and/or impairment of fibrinolysis, thereby increasing cardiovascular disease (CVD) risk. We measured the coagulation activation marker prothrombin fragment F1 + 2 (F1 + 2), fibrinogen, plasminogen activator inhibitor-1 activity (PAI1), interleukin-6 (IL6), insulin, lipids and lipoprotein(a) (Lp(a)), in 12 patients with chronic renal disease before and after gemfibrozil. Gemfibrozil significantly reduced triglycerides by 44% and increased HDL-cholesterol by 31% without significant change in LDL cholesterol. Before treatment, patients had increased F1 + 2, fibrinogen and IL6, but similar PAI1 compared with the controls, consistent with a hypercoagulable and persistent inflammatory state. Following treatment, F1 + 2 decreased to within the normal range and this reduction correlated with the decrease in triglycerides and inversely with the increase in HDL-cholesterol. A non-significant decrease in fibrinogen was inversely correlated with a significant increase in albumin. However, Lp(a) and PAI1 activity significantly increased whilst insulin and IL6 were unchanged. Gemfibrozil improved the uraemic dyslipidaemia...Continue Reading

Citations

Nov 7, 2000·The American Journal of Medicine·C CatenaL A Sechi
Feb 19, 2000·Current Opinion in Lipidology·G F Watts, S B Dimmitt
May 30, 2007·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Gursharan DograGerald Watts
Aug 17, 2004·American Heart Journal·Patricia J M BestRobert M Califf
Sep 8, 2004·Expert Review of Cardiovascular Therapy·Florian Kronenberg

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